Human cytomegalovirus seropositivity is associated with reduced patient survival during sepsis

  • \(\bf Background\) Sepsis is one of the leading causes of death. Treatment attempts targeting the immune response regularly fail in clinical trials. As HCMV latency can modulate the immune response and changes the immune cell composition, we hypothesized that HCMV serostatus affects mortality in sepsis patients. \(\bf Methods\) We determined the HCMV serostatus (i.e., latency) of 410 prospectively enrolled patients of the multicenter SepsisDataNet.NRW study. Patients were recruited according to the SEPSIS-3 criteria and clinical data were recorded in an observational approach. We quantified 13 cytokines at Days 1, 4, and 8 after enrollment. Proteomics data were analyzed from the plasma samples of 171 patients. \(\bf Results\) The 30-day mortality was higher in HCMV-seropositive patients than in seronegative sepsis patients (38% vs. 25%, respectively; \(\it p\) = 0.008; HR, 1.656; 95% CI 1.135–2.417). This effect was observed independent of age (\(\it p\) = 0.010; HR, 1.673; 95% CI 1.131–2.477). The predictive value on the outcome of the increased concentrations of IL-6 was present only in the seropositive cohort (30-day mortality, 63% vs. 24%; HR 3.250; 95% CI 2.075–5.090; \(\it p\) < 0.001) with no significant differences in serum concentrations of IL-6 between the two groups. Procalcitonin and IL-10 exhibited the same behavior and were predictive of the outcome only in HCMV-seropositive patients. \(\bf Conclusion\) We suggest that the predictive value of inflammation-associated biomarkers should be re-evaluated with regard to the HCMV serostatus. Targeting HCMV latency might open a new approach to selecting suitable patients for individualized treatment in sepsis.

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Author:Matthias UnterbergORCiDGND, Stefan Felix EhrentrautORCiDGND, Thilo BrachtORCiDGND, Alexander WolfORCiDGND, Helge HaberlGND, Alexander von BuschGND, Katharina RumpORCiDGND, Dominik ZieheGND, Maha BazziGND, Patrick ThonGND, Barbara SitekGND, Katrin Marcus-AlicORCiDGND, Malte BayerORCiDGND, Karin SchorkORCiDGND, Martin EisenacherORCiDGND, Björn EllgerGND, Daniel OswaldGND, Frank WapplerORCiDGND, Jérôme DefosseORCiDGND, Dietrich HenzlerORCiDGND, Thomas KöhlerORCiDGND, Alexander ZarbockGND, Christian PutensenGND, Jens-Christian ScheweGND, Ulrich FreyORCiDGND, Moritz AnftGND, Nina BabelORCiDGND, Eike SteinmannORCiDGND, Yannick BrüggemannGND, Mirko TrillingORCiDGND, Andreas SchlüterGND, Hartmuth Sebastian Burkhard NowakORCiDGND, Michael AdamzikORCiDGND, Tim RahmelORCiDGND, Björn KoosORCiDGND
URN:urn:nbn:de:hbz:294-125314
DOI:https://doi.org/10.1186/s13054-023-04713-1
Parent Title (English):Critical care
Publisher:BioMed Central, Part of Springer Nature
Place of publication:London
Document Type:Article
Language:English
Date of Publication (online):2024/04/15
Date of first Publication:2023/10/31
Publishing Institution:Ruhr-Universität Bochum, Universitätsbibliothek
Tag:Open Access Fonds
HCMV latency; Inflammatory biomarker; Mortality prediction
GND-Keyword:Sepsis
Volume:27
Issue:Artikel 417
First Page:417-1
Last Page:417-14
Note:
Article Processing Charge funded by the Deutsche Forschungsgemeinschaft (DFG) and the Open Access Publication Fund of Ruhr-Universität Bochum.
Institutes/Facilities:Knappschaftskrankenhaus Bochum, Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie
Dewey Decimal Classification:Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit
open_access (DINI-Set):open_access
Licence (English):License LogoCreative Commons - CC BY 4.0 - Attribution 4.0 International