Five cases of Cytomegalovirus-related rectal bleeding in COVID-19 immunocompetent patients have been reported in the country. The patients are from Delhi and were at Sir Ganga Ram Hospital.

In a press release dated June 29, the hospital informed that the patients came in complaining of rectal bleeding, which, upon diagnosis, was linked to Cytomegalovirus. All patients experienced this condition after testing positive for COVID19.

According to the Mayo Clinic, a non-profit American academic medical centre, Cytomegalovirus is a common virus, and once someone is infected, he or she is a carrier of the virus for life. It does not do anything to those with good immunity, but once immunity is compromised, it shows up as symptoms relating to areas including the liver, stomach and intestine.

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“During the second wave of COVID-19, in April-May 2021, we saw five cases of CMV infection in otherwise immunocompetent patients with COVID-19. These patients presented with pain in the abdomen and bleeding in stools. These patients presented with a mean of 20 to 30 days after the diagnosis of COVID-19,” said Anil Arora, chairman, Institute of Liver Gastroenterology and Pancreaticobiliary Sciences, Sir Ganga Ram Hospital.

The cases were from Delhi-NCR region and in the age group of 30-70 years, Arora said, adding that two of them also had a massive bleed. One required lifesaving surgery —  the right side of the colon was removed —  and one succumbed due to massive bleeding and severe COVID-19 chest disease.

“The other three patients were successfully treated with antiviral therapy with ganciclovir,” informed Arora.

COVID infection itself and the medicines used for its treatment (steroids) do suppress the immunity of patients and make them susceptible for uncommon infections with varied presentations, read the press statement.

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The hospital said Cytomegalovirus exists in 80 to 90 per cent of the Indians, in an asymptomatic form. Clinical presentation with symptoms secondary to CMV is usually seen in patients whose immunity is compromised.

“In 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 life,” said Praveen Sharma, senior consultant, gastroenterology department, Sir Ganga Ram Hospital.

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