Herpes Simplex Virus Re-Activation in Patients with SARS-CoV-2 Pneumonia: A Prospective, Observational Study

Background: Herpes simplex 1 co-infections in patients with COVID-19 are considered relatively uncommon; some reports on re-activations intensive-care units were published. The aim of the study was to analyze herpetic and their clinical manifestations hospitalized patients, performing HSV-1 PCR plasma twice a week. Methods: we conducted prospective, observational, single-center involving 70 consecutive severe/critical SARS-CoV-2 pneumonia tested for at Azienda Ospedaliero-Universitaria Modena. Results: these 21 (30.0%) showed detectable viremia 13 (62%) had clinically relevant infection corresponding 15 events (4 pneumonia, 5 herpes labialis, 3 gingivostomatitis, one encephalitis two hepatitis). positive more frequently treated steroids than negative (76.2% vs. 49.0%, p = 0.036) often underwent mechanical ventilation (IMV) (57.1% 22.4%, 0.005). In unadjusted logistic regression analysis, steroid treatment, IMV, higher LDH significantly associated an increased risk HSV1 re-activation (odds ratio 3.33, 4.61, 16.9, respectively). association use even stronger after controlling previous both tocilizumab IMV (OR 5.13, 95% CI:1.36–19.32, 0.016). effect size larger when restricting participants who high doses while there no evidence support Conclusions: our shows incidence virologically severe especially those steroids.