Reactivation of Herpes Simplex Virus Type 1 (HSV-1) Detected on Bronchoalveolar Lavage Fluid (BALF) Samples in Critically Ill COVID-19 Patients Undergoing Invasive Mechanical Ventilation: Preliminary Results from Two Italian Centers
Daniele Roberto Giacobbe, Stefano Di Bella, Silvia Dettori, Giorgia Brucci, Verena Zerbato, Riccardo Pol, Ludovica Segat, Pierlanfranco D’Agaro, Erik Roman‐Pognuz, Federica Friso, Luigi Principe, Umberto Lucangelo, Lorenzo Ball, Chiara Robba, Denise Battaglini, Andrea De Maria, Iole Brunetti, Nicolò Patroniti, Federica Briano, Bianca Bruzzone, Giulia Guarona, Laura Magnasco, Chiara Dentone, Giancarlo Icardi, Paolo Pelosi, Roberto Luzzati, Matteo Bassetti
Abstract
Reactivation of herpes simplex virus type 1 (HSV-1) has been described in critically ill patients with coronavirus disease 2019 (COVID-19) pneumonia. In the present two-center retrospective experience, we primarily aimed to assess the cumulative risk of HSV-1 reactivation detected on bronchoalveolar fluid (BALF) samples in invasively ventilated COVID-19 patients with worsening respiratory function. The secondary objectives were the identification of predictors for HSV-1 reactivation and the assessment of its possible prognostic impact. Overall, 41 patients met the study inclusion criteria, and 12/41 patients developed HSV-1 reactivation (29%). No independent predictors of HSV-1 reactivation were identified in the present study. No association was found between HSV-1 reactivation and mortality. Eleven out of 12 patients with HSV-1 reactivation received antiviral therapy with intravenous acyclovir. In conclusion, HSV-1 reactivation is frequently detected in intubated patients with COVID-19. An antiviral treatment in COVID-19 patients with HSV-1 reactivation and worsening respiratory function might be considered.