OBJECTIVE:: @entity2803 reactivation may complicate @entity3124 in latent carriers of the virus, even in @entity1 who were previously immunocompetent. @entity1 with @entity649 are considered to be prone for reactivation. Prophylactic antiviral therapy in immunocompetent @entity2803 seropositive @entity1 admitted to the ICU with @entity649 has therefore been proposed. We assessed @entity2803 seroprevalence as a risk factor for morbidity and mortality in @entity1 with @entity649 . DESIGN:: Prospective observational cohort study. We used the number of days alive and free of mechanical ventilation on day 28 as a composite outcome measure and used multivariable ordinal logistic regression analyses to adjust for potential confounders. SETTING:: ICUs of two tertiary care hospitals in The Netherlands. @entity1 :: We included all newly admitted @entity1 with @entity649 who received mechanical ventilation for at least 4 days. @entity1 with known immunocompromise and those receiving antiviral treatment prior to ICU admission were excluded. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: Over a 2-year period, 306 @entity1 were included, 209 (68%) of whom were @entity2803 seropositive. @entity2803 reactivation occurred in 53 of these cases (26%). One hundred @entity1 (33%) died or continued to be mechanically ventilated by day 28. After adjustment for confounding, @entity2803 seroprevalence was not associated with the primary outcome (crude odds ratio, 1.09; 95% CI, 0.70-1.70; adjusted odds ratio, 1.01; 95% CI, 0.64-1.59). Seroprevalence was also not associated with poor outcome in any of the prespecified subgroup analyses. However, a significant association was found in a post hoc subgroup of @entity1 who had developed @entity649 in a setting of @entity326 (adjusted odds ratio, 2.86; 95% CI, 1.32-6.23). The time course of pulmonary markers in survivors was comparable between the two serogroups. CONCLUSIONS:: @entity2803 seroprevalence is not associated with prolonged mechanical ventilation or increased mortality in critically ill @entity1 with @entity649 , with possible exception of @entity1 presenting with @entity326 . Therefore, a prevention strategy targeting an unselected cohort of seropositive @entity1 with @entity649 is unlikely to show any meaningful benefit.

XXXX Seroprevalence as a Risk Factor for Poor Outcome in Acute @entity649 *

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PATIENTS'] @entity2803 :: ('MESH:D003586', 'Disease') :: ['Cytomegalovirus', 'cytomegalovirus'] @entity326 :: ('MESH:D012772', 'Disease') :: ['septic shock'] @entity649 :: ('MESH:D012128', 'Disease') :: ['acute respiratory distress syndrome'] @entity3124 :: ('MESH:D016638', 'Disease') :: ['critical illness']
@entity2803 :: (MESH:D003586,Disease) :: ['Cytomegalovirus']
