Temporal trends in the clinical presentation, management, and outcomes of children with congenital cytomegalovirus infection.
22 affiliations
- 1Clinic of Infectious Diseases and Pediatric Department, Bulovka University Hospital, Prague, Czech Republic. [email protected].
- 2Third Faculty of Medicine, Charles University, Prague, Czech Republic. [email protected].
- 3Second Faculty of Medicine, Charles University, Prague, Czech Republic. [email protected].
- 4Department of Paediatric Infectious Diseases, Medical School, University of Patras, Patras, Greece.
- 5Instituto de Investigación Hospital, 12 de Octubre (i+12), Madrid, Spain.
- 6Third Department of Pediatrics, National and Kapodistrian University of Athens, ATTIKON General Hospital, Athens, Greece.
- 7Malalties Infecciosesi Resposta Inflamatòria Sistèmicaen Pediatria, Servei de Malalties Infecciosesi Patologia Importada, Institut de Recerca Pediàtrica Sant Joan de Déu, Barcelona, Spain.
- 8Universidad Complutense de Madrid, Madrid, Spain.
- 9Division of Neonatology, Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.
- 10Hospital Universitario La Paz, Instituto Investigación Hospital La Paz (IDIPaz), Madrid, Spain.
- 11Pediatric Infectious Diseases Unit, Hospital Universitario 12 de Octubre, Madrid, Spain.
- 12Hospital Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
- 13Pediatric Infectious Diseases and Immunodeficiencies Unit, Children's Hospital, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.
- 14Hospital Universitario Gregorio Marañón, Madrid, Spain.
- 15Unit of Pediatric Infectious Diseases and Vaccinology, Department of Woman Mother and Child, Lausanne University Hospital, Lausanne, Switzerland.
- 16Imperial College Healthcare NHS Trust, London, UK.
- 17Department of Otorhinolaryngology and Head & Neck Surgery, Vrije Universiteit Brussels, University Hospital UZ Brussel, Brussels Health Campus, De Poolster, Rehabilitation Centre, Brussels, Belgium.
- 18Main-Kinzig Clinics Gelnhausen, Gelnhausen, Germany.
- 19Hospital Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.
- 20Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece.
- 21Manchester University NHS Foundation Trust, Manchester, UK.
- 22CIBERINFEC: Centro de Investigación Biomédica en Red Enfermedades Infecciosas, Madrid, Spain.
Abstract
Congenital cytomegalovirus (cCMV) is the most common congenital infection and a leading cause of sensorineural hearing loss as well as neurodevelopmental impairment. In recent years, awareness, screening, and management strategies for cCMV have evolved. This study aimed to assess temporal changes in the clinical presentation, treatment, and outcomes of children diagnosed with cCMV infection. We conducted a retrospective cohort analysis using data from the CCMVnet registry ( www.ccmvnet.org ), an international multicenter database collecting anonymized data on children with confirmed cCMV infection. A total of 1653 patients diagnosed between 2011 and 2024 were included and divided into two cohorts: 2011-2016 (n = 566) and 2017-2024 (n = 1087). The year 2017 was selected as a pragmatic cutoff, corresponding to the year of publication of the European expert consensus statement on congenital CMV. Children were identified through antenatal, clinical, hearing-related, and newborn screening pathways. Symptomatic cCMV at birth was defined by the presence of at least one predefined clinical, laboratory, hearing, or neuroimaging finding based on previously published criteria. A comparative analysis between two distinct time periods was conducted, encompassing neonatal clinical findings, neuroimaging results, treatment strategies, and long-term outcomes. Newborns classified as symptomatic at birth decreased in the more recent cohort, from 49.2% in P1 to 44.2% in P2 (p = 0.07). The use of intravenous ganciclovir decreased from 7.3% to 2.8% (p < 0.001), while the use of oral valganciclovir alone increased from 43.8% to 78.7% (p < 0.001). Differences in long-term outcomes were observed between the two periods, with motor impairment at 12 months decreasing from 16.5% to 6.2% (p < 0.001) and any long-term sequelae at 36 months decreasing from 40.0% to 31.0% (p = 0.05).Conclusion
This study highlights temporal differences in the clinical spectrum, management, and outcomes of children with congenital CMV infection in Europe. The higher proportion of asymptomatic and mildly symptomatic children in the latter period may reflect changes in maternal and neonatal screening practices. The observed temporal differences provide insight into the evolving clinical landscape of cCMV diagnosis and management, while their underlying causes cannot be determined from the present data.What is known
• Congenital cytomegalovirus (cCMV) infection is the leading infectious cause of sensorineural hearing loss and neurodevelopmental impairment in children. • Clinical management of cCMV has evolved substantially over the last decade, particularly following the publication of the European expert consensus statement in 2017 and alongside expanding screening strategies.What is new
• In our cohort, children diagnosed with cCMV after 2017 presented with milder clinical manifestations and experienced fewer long-term sequelae than those diagnosed before 2017. • Temporal changes in diagnostic pathways, treatment practices, and clinical outcomes were observed between the two study periods.
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BibTeX
@article{bolchova2026temporal,
title = {{Temporal trends in the clinical presentation, management, and outcomes of children with congenital cytomegalovirus infection.}},
author = {Jitka Bolchová and Despoina Gkentzi and Roberto Pedrero Tomé and Garyfallia Syridou and Antoni Noguera-Julián and María Ríos-Barnés and Serena Salomé and Francesco Raimondi and Serena Villaverde and Fernando Baquero-Artigao and Paula Rodriguez-Molino and Danilo Buonsenso and Laura Martino and Beatriz Álvarez-Vallejo and Jesús Saavedra and Yves Fougere and Hermione Lyall and Ina Foulon and Horst Buxmann and Simona Zanette and Olga Tsiatsiou and Jessica Wan and Daniel Blázquez-Gamero and Vana Papaevangelou and cCMVnet Registry Study Group},
journal = {European journal of pediatrics},
year = {2026},
month = oct,
doi = {10.1007/s00431-026-07485-2},
url = {https://europepmc.org/article/MED/42873372},
note = {CC BY},
}
RIS
TY - JOUR
TI - Temporal trends in the clinical presentation, management, and outcomes of children with congenital cytomegalovirus infection.
AU - Jitka Bolchová
AU - Despoina Gkentzi
AU - Roberto Pedrero Tomé
AU - Garyfallia Syridou
AU - Antoni Noguera-Julián
AU - María Ríos-Barnés
AU - Serena Salomé
AU - Francesco Raimondi
AU - Serena Villaverde
AU - Fernando Baquero-Artigao
AU - Paula Rodriguez-Molino
AU - Danilo Buonsenso
AU - Laura Martino
AU - Beatriz Álvarez-Vallejo
AU - Jesús Saavedra
AU - Yves Fougere
AU - Hermione Lyall
AU - Ina Foulon
AU - Horst Buxmann
AU - Simona Zanette
AU - Olga Tsiatsiou
AU - Jessica Wan
AU - Daniel Blázquez-Gamero
AU - Vana Papaevangelou
AU - cCMVnet Registry Study Group
PY - 2026
DA - 2026/10/14
JO - European journal of pediatrics
DO - 10.1007/s00431-026-07485-2
UR - https://europepmc.org/article/MED/42873372
AB - Congenital cytomegalovirus (cCMV) is the most common congenital infection and a leading cause of sensorineural hearing loss as well as neurodevelopmental impairment. In recent years, awareness, screening, and management strategies for cCMV have evolved. This study aimed to assess temporal changes in the clinical presentation, treatment, and outcomes of children diagnosed with cCMV infection. We conducted a retrospective cohort analysis using data from the CCMVnet registry ( www.ccmvnet.org ), an international multicenter database collecting anonymized data on children with confirmed cCMV infection. A total of 1653 patients diagnosed between 2011 and 2024 were included and divided into two cohorts: 2011-2016 (n = 566) and 2017-2024 (n = 1087). The year 2017 was selected as a pragmatic cutoff, corresponding to the year of publication of the European expert consensus statement on congenital CMV. Children were identified through antenatal, clinical, hearing-related, and newborn screening pathways. Symptomatic cCMV at birth was defined by the presence of at least one predefined clinical, laboratory, hearing, or neuroimaging finding based on previously published criteria. A comparative analysis between two distinct time periods was conducted, encompassing neonatal clinical findings, neuroimaging results, treatment strategies, and long-term outcomes. Newborns classified as symptomatic at birth decreased in the more recent cohort, from 49.2% in P1 to 44.2% in P2 (p = 0.07). The use of intravenous ganciclovir decreased from 7.3% to 2.8% (p < 0.001), while the use of oral valganciclovir alone increased from 43.8% to 78.7% (p < 0.001). Differences in long-term outcomes were observed between the two periods, with motor impairment at 12 months decreasing from 16.5% to 6.2% (p < 0.001) and any long-term sequelae at 36 months decreasing from 40.0% to 31.0% (p = 0.05).Conclusion This study highlights temporal differences in the clinical spectrum, management, and outcomes of children with congenital CMV infection in Europe. The higher proportion of asymptomatic and mildly symptomatic children in the latter period may reflect changes in maternal and neonatal screening practices. The observed temporal differences provide insight into the evolving clinical landscape of cCMV diagnosis and management, while their underlying causes cannot be determined from the present data.What is known • Congenital cytomegalovirus (cCMV) infection is the leading infectious cause of sensorineural hearing loss and neurodevelopmental impairment in children. • Clinical management of cCMV has evolved substantially over the last decade, particularly following the publication of the European expert consensus statement in 2017 and alongside expanding screening strategies.What is new • In our cohort, children diagnosed with cCMV after 2017 presented with milder clinical manifestations and experienced fewer long-term sequelae than those diagnosed before 2017. • Temporal changes in diagnostic pathways, treatment practices, and clinical outcomes were observed between the two study periods.
SN - 0340-6199
SN - 1432-1076
ER -