High incidence of Epstein-Barr virus, cytomegalovirus, and human-herpes virus-6 reactivations in critically ill patients with COVID-19

Infect Dis Now. 2021 May;51(3):296-299. doi: 10.1016/j.idnow.2021.01.005. Epub 2021 Jan 18.


Background: Systemic reactivation of herpesviruses may occur in intensive care unit (ICU) patients and is associated with morbidity and mortality. Data on severe Coronavirus disease-19 (COVID-19) and concomitant reactivation of herpesviruses are lacking.

Methods: We selected patients admitted to ICU for confirmed COVID-19 who underwent systematic testing for Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human-herpes virus-6 (HHV-6) DNAemia while in the ICU. We retrospectively analysed frequency, timing, duration and co-occurrence of viral DNAemia.

Results: Thirty-four patients were included. Viremia with EBV, CMV, and HHV-6 was detected in 28 (82%), 5 (15%), and 7 (22%) patients, respectively. EBV reactivation occurred early after ICU admission and was associated with longer ICU length-of-stay.

Conclusions: While in the ICU, critically ill patients with COVID-19 are prone to develop reactivations due to various types of herpesviruses.

Keywords: COVID-19; Cytomegalovirus; Epstein–Barr virus.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / complications*
  • Critical Illness / epidemiology
  • Cytomegalovirus / physiology*
  • Female
  • France / epidemiology
  • Herpesvirus 4, Human / physiology*
  • Herpesvirus 6, Human / physiology*
  • Humans
  • Incidence
  • Intensive Care Units
  • Latent Infection / complications*
  • Male
  • Middle Aged
  • Retrospective Studies
  • SARS-CoV-2
  • Virus Activation*