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However, its maximum duration without secondary infections remains unclear. We aimed to evaluate the utility of monitoring cytomegalovirus (CMV) infection in patients with COVID\u201019 and estimate the maximum duration of systemic corticosteroid therapy without secondary infections. We included 59 patients with severe COVID\u201019 without CMV infection on admission to the intensive care unit (ICU). All patients received systemic corticosteroid therapy under invasive mechanical ventilation, with examination for plasma CMV\u2010deoxyribonucleic acid (DNA) levels during the ICU stay. We analyzed the correlations among patient characteristics, CMV infection, diseases, and patient mortality. CMV infections were newly identified in 15 (25.4%) patients; moreover, anti\u2010CMV treatment was administered to six (10.2%) patients during the ICU stay. Four (6.8%) patients had secondary infection\u2010related mortality. The cumulative incidences of CMV infection and anti\u2010CMV treatment during the ICU stay were 26.8% (95% confidence interval [CI], 15.8%\u201339.0%) and 12.3% (95% CI, 4.8%\u201323.4%), respectively. Furthermore, the median duration of systemic corticosteroid therapy without CMV infection was 15 days (95% CI, 13\u201316 days). The presence of CMV infection was associated with mortality during the ICU stay (<jats:italic>p<\/jats:italic>\u2009=\u20090.003). Monitoring plasma CMV\u2010DNA levels could facilitate the detection of secondary CMV infection due to prolonged systemic corticosteroid therapy. The duration of systemic corticosteroid therapy for COVID\u201019 should be limited.<\/jats:p>","DOI":"10.1002\/jmv.27421","type":"journal-article","created":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T10:28:38Z","timestamp":1635416918000},"page":"1067-1073","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Prolonged corticosteroid therapy and cytomegalovirus infection in patients with severe COVID\u201019"],"prefix":"10.1002","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5489-5079","authenticated-orcid":false,"given":"Yuji","family":"Yamamoto","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine and Clinical Immunology Osaka University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Shiroyama","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and 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