Long-Term Clinical, Audiological, Visual, Neurocognitive and Behavioral Outcome in Children With Symptomatic and Asymptomatic Congenital Cytomegalovirus Infection Treated With Valganciclovir

Arianna Turriziani Colonna; Danilo Buonsenso; Davide Pata; Gilda Salerno; Daniela P R Chieffo; Domenico M Romeo; Valerio Faccia; Guido Conti; Fernando Molle; Antonio Baldascino; Chiara De Waure; Anna Acampora; Rita Luciano; Rosaria Santangelo; Piero Valentini

doi:10.3389/fmed.2020.00268

Long-Term Clinical, Audiological, Visual, Neurocognitive and Behavioral Outcome in Children With Symptomatic and Asymptomatic Congenital Cytomegalovirus Infection Treated With Valganciclovir

Front Med (Lausanne). 2020 Jul 24:7:268. doi: 10.3389/fmed.2020.00268. eCollection 2020.

Authors

Arianna Turriziani Colonna¹, Danilo Buonsenso^{2

3}, Davide Pata¹, Gilda Salerno¹, Daniela P R Chieffo^{1

4}, Domenico M Romeo^{1

4}, Valerio Faccia⁵, Guido Conti^{6

7}, Fernando Molle^{6

8}, Antonio Baldascino^{6

8}, Chiara De Waure⁹, Anna Acampora^{1

10}, Rita Luciano^{1

2}, Rosaria Santangelo^{3

11}, Piero Valentini^{1

2}

Affiliations

¹ Istituto di Pediatria, Università Cattolica del Sacro Cuore, Rome, Italy.
² Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
³ Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
⁴ Istituto di Neuropsichiatria, Università Cattolica del Sacro Cuore, Rome, Italy.
⁵ Unit of Pediatrics, Department of Gynecologic, Pediatric and Neonatologic Sciences, "Sant'Andrea" University Hospital, University "Sapienza" of Rome, Rome, Italy.
⁶ Department of Aging, Neurologic, Orthopedic and Head and Neck Science, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
⁷ Istituto di Otorinolaringoiatria, Università Cattolica del Sacro Cuore, Rome, Italy.
⁸ Istituto di Oculistica, Università Cattolica del Sacro Cuore, Rome, Italy.
⁹ Department of Experimental Medicine, University of Perugia, Perugia, Italy.
¹⁰ Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy.
¹¹ Department of Microbiology and Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Abstract

Cytomegalovirus (CMV) is the most common cause of congenital infection in humans. There are no enough data on long-term outcome of newborns with congenital CMV (cCMV) infection, particularly for those asymptomatic at birth. For this reason, we performed this study to evaluate long-term audiological, visual, neurocognitive, and behavioral outcome in patients with symptomatic and asymptomatic cCMV infection treated with oral Valganciclovir (VGC). Thirty-six newborns with confirmed cCMV infection were evaluated: 12 (33.3%) symptomatic at birth and 24 asymptomatic (66.7%). No one had cognitive impairment. Cognitive assessment scales resulted abnormal in 4/35 patients (11.4%). 11/21 patients (52.4%) achieved abnormal scores in neuropsychological tests. The language evaluation gave pathological results in 6/21 (28.5%) patients. 6/35 patients (17.1%) developed SNHL, all symptomatic at birth except one. None of the 34 patients evaluated developed CMV retinopathy. Our study shows that both symptomatic and asymptomatic newborns with cCMV infection develop long-term sequelae, particularly in the behavioral and communicative areas, independently from the trimester of maternal infection.

Keywords: congenital cytomegalovirus; congenital infections; hearing loss; neurocognitive outcome; valganciclovir.