These studies indicate that colectomy rates are higher in patients with CMV colitis compared to those without concurrent CMV.35 Older age, male gender, comorbidities, low albumin level, and tissue-CMV were associated with increased risk of colectomy.79 However, there is another emerging concept in IBD colitis named “innocent bystander” in which the CMV infection itself produces no significant detrimental effect on the course of IBD.82 Some studies have shown examples of active CMV infection in colitis patients who respond to steroid therapy without needing antivirals.83 Here, ALB is linked to cytomegalovirus infection.