5 Covid-19 patients suffered rectal bleeding due to CMV infection, one dies

Five Covid19 patients have suffered cytomegalovirusrelated rectal bleeding at a leading private facility here during the second wave of the pandemic hospital authorities said on Tuesday and claimed it was being reported for the first time in immunocompetent personsThese patients face the problem on an average 2030 days after the diagnosis of Covid19 doctors at Sir Ganga Ram Hospital saidUntil now it affected only immunocompromised patients posttransplant cancer AIDS etc but this is the first time in India that cases of CMVrelated rectal bleeding in Covid19 immunocompetent patients have been reported a spokesperson of the hospital saidAlso Read Pregnancy doesnrsquot increase risk of Covid19 infection Health MinistryAccording to Prof Anil Arora chairman Institute of Liver Gastroenterology and Pancreaticobiliary Sciences at the hospital During the second wave of the pandemic in AprilMay we have seen five cases of CMV infection in otherwise immunocompetent patients with Covid19These patients presented with pain in abdomen and bleeding during stool discharge None of them had other predisposing immunosuppressed states accounting for this viral infection he saidCovid19 infection itself and the medicines used for its treatment like steroids do suppress the immunity of patients and make them susceptible for uncommon infections with varied presentations the hospital said in a statementOne such opportunistic infection is from CMV Cytomegaloirus exists in 80 to 90 per cent of the Indian population in asymptomatic form as our immunity is strong enough to make it clinically asymptomatic Clinical presentation with symptoms secondary to CMV is usually seen in patients whose immunity is compromised it saidBut in these five cases all patients presented with low lymphocyte count 610 per cent as against a normal of 20 to 40 per cent indicating Covidinduced suppression of immunity predisposing them to symptomatic reactivation of CMV infection doctors saidThese patients in age group of 3070 are from DelhiNCR and four had presented with lower gastrointestinal bleed which is bleeding in stools and one of them presented with intestinal obstruction the statement saidTwo of them had massive bleeding one requiring emergency lifesaving surgery in the form of removal of right side of the colon while one of them succumbed due to massive bleeding and severe Covid19 chest disease the hospital saidOther three patients were successfully treated with antiviral therapy with ganciclovir said AroraCytomegalovirus colitis was confirmed by PCR testing for CMV viremia and tissue biopsy from the large intestine which showed intranuclear inclusion bodies which was further confirmed to be due to CMV infection by the specific immunohistochemistry stains said Dr Sunila Jain senior consultant pathologist at the hospitalIn such cases a high index of suspicion and timely intervention in the form of an early diagnosis and effective antiviral therapy can save many a precious lives opined Dr Praveen Sharma senior consultant gastroenterology department at the Sir Ganga Ram HospitalThis story has been sourced from a third party syndicated feed agencies Midday accepts no responsibility or liability for its dependability trustworthiness reliability and data of the text Midday managementmiddaycom reserves the sole right to alter delete or remove without notice the content in its absolute discretion for any reason whatsoever