Predicting factors in children with positive dry blood spot testing for congenital Cytomegalovirus infection

This study aims to characterize the hearing loss of children diagnosed with congenital Cytomegalovirus (cCMV) through dry blood spot (DBS) testing and seeks to determine factors associated with a positive result.

Retrospective chart review.

Tertiary medical center.

A retrospective chart review was performed on patients who had undergone DBS testing for cCMV at Primary Children's Hospital between November 2016 and February 2024. The outcomes analyzed were hearing loss type, progression, severity, laterality, and CMV severity. Statistical significance was assessed using Fisher's exact test and Kruskal-Wallis test.

Data from 79 children revealed that 24.1 % tested positive for cCMV. Most patients were tested because of a failed NBHS or hearing loss (69.6 %). Non-hearing loss presentations also yielded a positive DBS result (Central nervous system abnormality [CNS] being the most common). A significant percentage (36.8 %) of the DBS positive cohort had CNS disease. All had an asymmetric loss compared to 39.3 % with hearing loss in the DBS-negative cohort (p < 0.01, OR 6.125 (1.99-18.79)). No significant difference was observed in hearing loss severity or progression between cCMV DBS positive and negative patients.

DBS testing is indicated for idiopathic SNHL and in some cases for non-hearing loss presentation. Those with a positive CMV DBS result are at risk for CNS disease and usually have asymmetric SNHL.