Ann Med. 2020 Aug 17:1-13. doi: 10.1080/07853890.2020.1811888. Online ahead of print.
Background: The impact of cytomegalovirus infection in elderly subjects remains unclear. This study examined the relationship between humoral immune response to cytomegalovirus (CMV) and all-cause mortality in a cohort of elderly hospitalized patients.Methods: Data were obtained from a random sample of 715 patients (≥ 65 years old) admitted for any cause in a third level hospital. Serum IgG antibody against CMV were determined by enzyme-linked immunosorbent (ELISA) assay.Results: A total of 480 deaths occurred in seropositive patients (n = 671) during a follow-up of 7.6 years (mean, 4.6); of which 112 patients died in-hospital or within 30 days after discharge (short-term mortality). For patients with CMV IgG antibody levels in the highest quartile compared with lower quartile, fully adjusted models showed that mortality was 1.40 times (95% CI 1.05-1.86) and 2.20 times (95% CI 1.15-4.21) higher, respectively. The exclusion of patients with cardiovascular disease (angina, myocardial infarction, heart failure, peripheral artery disease, or stroke) increases the risk of long-term (HR 2.22, 95% CI 1.36-3.62) and short-term mortality (OR 3.18, 95% CI 1.40-7.24).Conclusions: Increased IgG antibody levels against CMV are associated with increased short and long-term mortality in elderly hospitalized patients, especially in the patients without cardiovascular disease.