Cytomegalovirus DNAemia in infants with community-acquired pneumonia complicated by respiratory syncytial virus infection: Risk factors and impact on disease severity

Background This study aims to evaluate the incidence and risk factors for cytomegalovirus (CMV) DNAemia and its association with disease severity in infants with community-acquired pneumonia (CAP) complicated by respiratory syncytial virus (RSV) infection. Methods In this retrospective, cross-sectional study, we investigated the clinical characteristics of consecutive infants diagnosed with CAP complicated with RSV infection and circulatory whole blood CMV DNA on admission. Using binary logistic regression analysis, the clinical data of these infants were analyzed to identify risk factors for disease severity and CMV DNAemia. Results In all, 241 infants with CAP complicated by RSV infection were enrolled in this study. Fifty-five (22.8%) of these infants had CMV DNAemia. Disease severity was greater in infants with CMV DNAemia than in those without. Additionally, CMV DNAemia (odds ratio [OR], 5.517; 95% confidence interval [CI], 1.839–16.553; P  = 0.002) was found to be an independent risk factor for pediatric intensive care unit admission. Furthermore, age (+ 1 month; OR, 0.772; 95% CI, 0.617–0.965; P  = 0.023), possible bacterial coinfection (OR, 2.392; 95% CI, 1.115–5.121; P  = 0.025), and peripheral leukocyte count (+ 1 × 10 ⁹ /L; OR, 1.220; 95% CI, 1.093–1.362; P  < 0.001) were independent risk factors for CMV DNAemia. Conclusions Young age, possible bacterial coinfection, and higher peripheral leukocyte count were associated with an increased risk of CMV DNAemia, while infants with CMV DNAemia had greater disease severity than those without. Clinical trial number: Not applicab