Positive Epstein–Barr virus detection and mortality in respiratory failure patients admitted to the intensive care unit

Abstract Background Epstein–Barr virus (EBV) infection may induce immune suppression in several ways, which may influence the proper host response to other pathogens and lead to a bad outcome of critically ill patients. Methods This was a single‐center, retrospective, observational study. All patients admitted to an ICU because of respiratory failure were included. EBV detection from lower respiratory tract (LRT) and serum samples were routinely performed. Results Twenty‐eight consecutive cases who were admitted to the ICU at high‐risk for an infection or clinical signs of an infection were included in our study. Among the 28 patients, 15 were LRT‐positive for EBV (53.6%), and 8 were seropositive for EBV (28.6%). Among the LRT EBV‐positive patients, pneumonia was the main indication for ICU admission (93.3%), and in LRT EBV‐negative patients, acute exacerbation of COPD (AECOPD) was another indication for ICU admission (46.2%). The CD3+ T cell count (especially the CD3+CD8+ T cell count) was lower than the normal range in LRT‐ and serum EBV‐positive patients; these count were in the normal range in EBV‐negative patients. The ICU mortality was 32.1% for all patients. The mortality rate was significantly higher in patients who were seropositive for EBV than seronegative patients (62.5% vs 20.0%). No differences were shown between any outcome parameters for LRT EBV‐positive and ‐negative patients. Conclusions This study showed that EBV DNA is detected in LRT and serum samples of a significant number of ICU patients with respiratory failure, and seropositivity for EBV was associated with mortality. This finding maybe correlated with a low CD3+CD8+ T cell count.