Herpes Simplex Virus Bronchopneumonitis in Critically Ill Patients with Acute on Chronic Liver Failure: A Retrospective Analysis

(1) Background: Critically ill patients are frequently diagnosed with pulmonary Herpes simplex virus-1 (HSV) reactivation, which then can lead to HSV bronchopneumonitis and is associated with higher mortality and longer mechanical ventilation. For the particular subgroup of critically ill patients with acute on chronic liver failure (ACLF), however, the impact of HSV reactivation is unknown. We investigated the impact of HSV reactivation in these patients. (2) Methods: We conducted a retrospective analysis, evaluating data from 136 mechanically ventilated patients with ACLF between January 2016 and August 2023. Clinical parameters were compared between patients with and without HSV bronchopneumonitis. (3) Results: 10.3% were diagnosed with HSV bronchopneumonitis (HSV group). Mortality did not differ between the HSV and non-HSV group (85.7% vs. 75.4%, p = 0.52). However, the clinical course in the HSV group was more complicated as patients required significantly longer mechanical ventilation (14 vs. 21 days, p = 0.04). Furthermore, fungal superinfections were significantly more frequent in the HSV group (28.6% vs. 6.6%, p = 0.006). (4) Conclusions: Mortality of critically ill patients with ACLF with HSV bronchopneumonitis was not increased in spite of the cirrhosis-associated immune dysfunction. Their clinical course, however, was more complicated with significantly longer mechanical ventilation

Need for ICU and outcome of critically ill patients with COVID-19 and haematological malignancies: results from the EPICOVIDEHA survey

The risk for a severe coronavirus disease 2019 (COVID-19) with need for an intensive care unit (ICU) admission in a non-immunocompromised vaccinated population dropped from 5% at the beginning of the pandemic to at least 0.2% and is still decreasing since the omicron strain dominates the COVID-19 pandemic [1]. Beyond the risk factors identified for a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection like male sex, older age, and comorbidities such as cardiovascular disease, lung disease or obesity, patients with a history of malignancy, specifically patients with haematological malignancy, are prone to develop a complicated SARS-CoV-2 infection with need for ICU which is still associated with poorer clinical outcome [2,3,4,5,6,7,8,9,10,11,12,13,14,15]. The circumstances of a widely heterogenous population with regards to the type of haematological malignancy, extent of disease, haematological malignancy treatment history, [16,17,18] and baseline performance status are even more challenging in the environment of an ICU [19]. Although, data referring to critically ill COVID-19 patients regarding treatment strategies and outcome are widely available, data referring to critically ill patients with haematological malignancy are scarce and underreported [20]. The aim of this study is to analyze the epidemiology, risk factors and outcome of patients with haematological malignancy with need for an ICU setting using the data from the large-scale EPICOVIDEHA registry of the European Hematology Association—Scientific Working Group Infectious in Hematology (EHA-SWG) [21].Open Access funding enabled and organized by Projekt DEAL. EPICOVIDEHA has received funds from Optics COMMIT (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223).Peer reviewe