WIP 87 - Universal Congenital CMV screening: does “asymptomatic” always mean “asymptomatic”?

Publication Number: WIP 87.7561

Stephanie Trimboli, NewYork-Presbyterian Komansky Children’s Hospital, New York, NY, United States; Karen Acker, Weill Cornell Medicine, New York, NY, United States; Melanie Dubois, Weill Cornell Medicine, New York City, NY, United States; Jin-Young Han, Weill Cornell Medicine, New York, NY, United States; Christine M Salvatore, Weill Cornell Medicine, New York, NY, United States

Background: Congenital cytomegalovirus (cCMV) is the most common congenital infection with an estimated incidence of 0.5 to 1% of all live births. While an estimated 90% of newborns are considered asymptomatic at birth with a normal physical exam and hearing screen, up to 20% or more will develop long-term sequelae (i.e. sensorineural hearing loss and cognitive impairment). Currently, cCMV screening is targeted to symptomatic newborns, but this approach may miss newborns with cCMV who could potentially benefit from antiviral treatment and long-term developmental and audiology follow up. In October 2023, the New York State Department of Health (NYS DOH) implemented universal cCMV screening via Dry Blood Spot (DBS) as part of their Newborn Screening Program.

Objective: Our first objective is to describe the neonatal features of infants diagnosed at birth with cCMV via universal screening. The second is to determine the frequency of cCMV signs in apparently asymptomatic newborns once a workup is completed.

Design/Methods: From October 2, 2023 to October 1, 2024, all newborns who screened positive for cCMV on the DBS were referred to a specialized center. Weill Cornell Medicine was designated by the NYS DOH as one of the specialized cCMV Centers. All newborns with a positive DBS born in most areas of Manhattan and Queens were referred to our center for a confirmatory urine CMV PCR and center-specific standard of care (SOC) work up, which included laboratory analysis (CBC, liver function and plasma viral load), brain ultrasound, brain MRI, abdominal ultrasound, ophthalmology exam and diagnostic Auditory Brainstem Response testing.
59 newborns were referred to our clinic; 56 had a positive urine PCR and 3 were negative (false positive). Institutional IRB approval (#234709) was obtained to collect SOC data from medical records and to follow prospectively all the referred infants after an informed consent was signed.
Currently, we have data for 20/56 true positives and anticipate completing data collection in the next 2 months. Descriptive statistical analyses will be applied.