GLOBAL estimates show cytomegalovirus linked lower respiratory infections remain a persistent cause of death worldwide.
Using data from the MICROBE database, investigators analyzed cytomegalovirus associated lower respiratory infections from 1990 to 2021 across age groups, sexes, regions and Socio-demographic Index categories. They quantified deaths, disability adjusted life years and age standardized rates to describe temporal trends in the global burden and to highlight vulnerable populations.
Cytomegalovirus Lower Respiratory Infections Over Time
Globally, disability adjusted life years due to cytomegalovirus attributable lower respiratory infections decreased from an estimated 734,208 in 1990 to 530,465 in 2021. Over the same period, deaths rose from 16,141 to 19,235. The age standardized disability adjusted life year rate declined from 13.89 to 6.95, while the age standardized mortality rate fell from 0.40 to 0.24. These patterns indicate that cytomegalovirus lower respiratory infections are becoming less frequent at a population level, yet they still translate into a substantial absolute number of deaths. Projections from the same modelling framework suggest that both age standardized mortality and disability related to these infections are likely to continue decreasing over the next 30 years.
Children, The Elderly, and Global Inequities
In 2021, the burden of cytomegalovirus lower respiratory infections was highest in regions with a low Socio-demographic Index, reflecting persistent inequities in prevention, diagnosis and access to care. Across the study period, age standardized mortality and disability adjusted life year rates declined as Socio-demographic Index increased, underlining the protective effect of socioeconomic development. Children and the elderly were identified as groups with particularly high disease burden, emphasizing the vulnerability of immune immature and immune senescent populations to cytomegalovirus related lower respiratory infections.
Implications For Clinical Practice and Policy
For clinicians, these findings reinforce cytomegalovirus as a relevant pathogen in severe lower respiratory infections, especially in settings where health systems and living conditions remain constrained. The authors highlight an urgent need for targeted and cost-effective interventions to prevent and reduce cytomegalovirus associated lower respiratory infections, particularly in low Socio-demographic Index regions, children, and older adults. For U.S. based healthcare professionals, the data support continued attention to cytomegalovirus in global health planning and underscore the importance of recognizing high risk groups who may present with severe lower respiratory disease in both domestic and international care settings.
Reference: Zhang W et al. Global burden of lower respiratory infections attributable to cytomegalovirus, 1990-2021: a systematic analysis from the MICROBE database. Front Microbiol. 2025;16:1693635.
