Discussion:
Since the beginning of the COVID 19 pandemic, the world is struggling to
cope up with the infection and its aftermath. There are many associated
complications and co-infections. Some of these include myocardial
infarction, stroke, pulmonary embolism, various viruses, and fungi
co-infection like CMV, EBV and currently mucormycosis (also known as
black fungus) is also seen in many cases with high mortality rates
[5,6,7]. CMV viremia is common in the immunocompromised state
especially in solid organ transplant patients [8]. However, an
immunosuppressive state due to dysregulated immunity or certain immune
modulators like Tocilizumab or steroids, in COVID 19 patients, can lead
to CMV viremia as seen in our case and in the literature as well
[9,10,11]. We performed a literature review of articles on Google
Scholar using advance search option with following keywords in title
“allintitle: COVID 19 and cytomegalovirus and Pubmed search strategy
with following keywords respectively ((((cytomegalovirus[Title]) OR
(CMV[Title]))) AND ((((COVID 19[Title]) OR (SARS COV
2[Title])) OR (coronavirus disease[Title])))). We managed to
find approximately 40 articles on CMV viremia in COVID 19 patients. Upon
screening, a total of 11 articles of severe COVID 19 infection that did
not have any underlying immunosuppressive state or malignancy were
selected (Table 1) [12,13,14,15,16,17,18,19,20,21,22], in order to
correlate with the management strategy in our patient.