Discussion:
Since the beginning of the COVID 19 pandemic, the world is struggling to cope up with the infection and its aftermath. There are many associated complications and co-infections. Some of these include myocardial infarction, stroke, pulmonary embolism, various viruses, and fungi co-infection like CMV, EBV and currently mucormycosis (also known as black fungus) is also seen in many cases with high mortality rates [5,6,7]. CMV viremia is common in the immunocompromised state especially in solid organ transplant patients [8]. However, an immunosuppressive state due to dysregulated immunity or certain immune modulators like Tocilizumab or steroids, in COVID 19 patients, can lead to CMV viremia as seen in our case and in the literature as well [9,10,11]. We performed a literature review of articles on Google Scholar using advance search option with following keywords in title “allintitle: COVID 19 and cytomegalovirus and Pubmed search strategy with following keywords respectively ((((cytomegalovirus[Title]) OR (CMV[Title]))) AND ((((COVID 19[Title]) OR (SARS COV 2[Title])) OR (coronavirus disease[Title])))). We managed to find approximately 40 articles on CMV viremia in COVID 19 patients. Upon screening, a total of 11 articles of severe COVID 19 infection that did not have any underlying immunosuppressive state or malignancy were selected (Table 1) [12,13,14,15,16,17,18,19,20,21,22], in order to correlate with the management strategy in our patient.