L’infezione congenita da CMV: follow-up a lungo termine in bambini con diagnosi precoce tramite screening neonatale

Objectives: Congenital cytomegalovirus infection (cCMV) can cause long-term neurocognitive, auditory, and visual sequelae. This study describes the long-term clinical sequelae and neuroradiological abnormalities in children identified through neonatal screening for congenital cytomegalovirus (cCMV) infection and followed for at least 2 years at a Tertiary Level Audiology Center. Methods: Neonatal and follow-up audiological data, clinical and virological assessments at birth, and ophthalmological, neuropsychiatric, and neuroradiological abnormalities compatible with cCMV were collected. Spearman’s correlation coefficient (rho-ρ) was used to assess correlations between parameters. Results: 61 neonates with cCMV were identified through neonatal screening for cCMV, with diagnosis primarily confirmed by PCR on urine collected within the first 15 days of life. 17 children were premature (average: 33.5 weeks). 16 patients (26.2%) were admitted to the neonatal intensive care unit. Among the 35 symptomatic neonates (57.3%), 19 received antiviral therapy. 20 children presented with sensorineural hearing loss, of which 85% were referred after neonatal hearing screening, while 15% received Pass results at the neonatal hearing screening. 5/20 children (25%) had isolated hearing loss, while 15/20 (75%) had it in association with other sequelae. In 5/20 patients (25%), progression of the hearing threshold was observed. 13/20 children received hearing aids, and of these, 8 subsequently underwent cochlear implantation. 24 patients (34.3%) had neurocognitive abnormalities, and 10 (17%) had ophthalmological abnormalities. 30 children underwent magnetic resonance imaging, which showed abnormalities compatible with cCMV in 63.3% of cases. Conclusions: This study highlights the long-term sequelae of cCMV in children identified early, emphasizing the importance of early diagnosis and multidisciplinary follow-up.