cytomegalovirus reactivation in postrenal transplant patients immediately in association with coronavirus disease 2019 (covid-19) infection: a case report of 2 patients and a brief review of the literature

Introduction: the coronavirus disease 2019 (covid-19) infection has been associated with multiple opportunistic infections, including secondary cytomegalovirus (cmv) reactivation. several cases of cmv syndrome and invasive cmv infection have been reported following severe covid-19 infection worldwide during the covid-19 pandemic in both immunocompetent and immunosuppressed patients. a case-control study conducted in india showed that during the first and second waves, cmv was the most common co-infection among fatal cases of severe covid-19 lung infection in indian renal transplant recipients. case presentation: we present 2 cases of cmv disease in postrenal transplant patients who developed clinical manifestations of cmv co-infection after mild covid-19 infection during the fourth wave of covid-19 infection in india. in both cases, cmv infection was treated by discontinuing mycophenolate mofetil and administering ganciclovir injections. however, the treatment resulted in 2 contrasting clinical outcomes: cure and death. conclusions: we reviewed the recent literature on the increased incidence of cmv reactivation after both covid-19 infection and vaccination in immunocompetent and immunocompromised populations. subsequently, we discussed some clinical questions relevant to the population of postrenal transplant recipients after the detection of mild covid-19 infection.