Publication date: May 12, 2026
Critically ill patients with COVID-19 frequently develop viral reactivation, yet the clinical significance of herpes simplex virus type 1 (HSV-1) and cytomegalovirus (CMV) remains a matter of debate. We conducted a retrospective single-center study of 455 consecutive intensive care unit (ICU) patients with confirmed SARS-CoV-2 infection between March 2020 and December 2021. Patients underwent screening for HSV-1 and CMV in whole blood and respiratory samples. A multivariable model was used to independently investigate risk factors associated with mortality. The mean age was 57 years (range: 13-94 years), and 316 (69%) were male. During a median ICU stay of 14 (0-90) days, viral reactivation (either HSV-1 or CMV or both) occurred in 164 (36%) patients. HSV-1 and CMV co-reactivation was detected in 57 (13%) patients, isolated HSV-1 reactivation was observed in 54 (12%) patients and isolated CMV reactivation in 53 (12%) patients. Median time from ICU admission to viral detection was 4 days, with a stepwise increase with longer ICU stay. Detection of HSV-1 was associated with decreased ICU survival (32% versus 67%; p
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Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | critically ill |
| disease | MESH | COVID-19 |
| disease | MESH | herpes simplex |
| pathway | REACTOME | SARS-CoV-2 Infection |
| pathway | REACTOME | Reproduction |
| disease | MESH | Cancer |
| disease | MESH | Cytomegalovirus Infections |