Reactivation of Epstein–Barr virus (<i>Herpesviridae: Lymphocryptovirus</i>, HHV-4) infection during COVID-19: epidemiological features

Abstract

Introduction. Immunodeficiency underlying the development of severe forms of new coronavirus infection may be the result of mixed infection with SARS-CoV-2 and other pathogens, including Epstein–Barr virus (EBV).The aim is to study the prevalence and epidemiological features of co-infection with SARS-CoV-2 and EBV. Material and methods. A cross-sectional randomized study was conducted in Moscow region from March to May 2020. Two groups were examined for EBV-markers: hospital patients (n = 95) treated for SARS-CoV-2 infection and blood donors (n = 92).Results. With equal EBV prevalence the detection of active infection markers in donors (10.9%) was noticeably lower than in SARS-CoV-2 patients (80%). Significant differences in this indicator were also found when patients from subgroups with interstitial pneumonia with the presence (96.6%) and absence (97.2%) of SARS-CoV-2 in the nasopharyngeal smear were compared with the subgroup of patients with mild COVID-19 (43.3%). The average IgG VCA and IgG EBNA positivity coefficients in donor group were higher than in patient group (p &lt; 0.05). Patients with active EBV infection markers were significantly more likely to have pneumonia, exceeding the reference values of ALT and the relative number of monocytes (odds ratio – 23.6; 3.5; 9.7, respectively).Discussion. The present study examined the incidence and analyzed epidemiological features of active EBV infection in patients with COVID-19.Conclusion. A significantly higher rate of detection of active EBV infection markers in hospital patients indicates a combined participation SARS-CoV-2 and EBV in the development of interstitial pneumonia. Low levels of specific IgG EBV serve as predictors of EBV reactivation. Exceeding the reference values of ALT and the relative number of monocytes in patients should serve as a reason for examination for active EBV infection markers.

COVID-19 infection and vaccines: potential triggers of Herpesviridae reactivation

“…The course of COVID-19 disease may be aggravated in patients that undergo EBV reactivation: these patients had a higher mortality rate and received more immuno-supportive treatment than SARV-CoV-2 patients without EBV coinfection. 28 In fact, Solomay TV et al 29 reported that severe disease and pneumonitis were more common among patients with EBV coinfection. These patients have a more frequent fever, elevated inflammation markers (C-reactive protein), and increased liver enzyme levels.…”

The Contribution of Human Herpes Viruses to γδ T Cell Mobilisation in Co-Infections

“…Remaining Vδ2 cells displayed markers of activation, suggesting activation and traffic to the lung, similar to what was observed in influenza infection in mice. Again, the reactivation of EBV in severe COVID-19 disease is a factor of morbidity and complications, but the reactivation of other HSVs can also affect the course of disease [35,[264][265][266][267][268]. How this affects γδ T cells and their putative protective or deleterious activity is unknown.…”

Long-COVID und Post-COVID-Syndrom

“…1).Wird eine präinfektiöse Dysbiose nachgewiesen, können die entsprechenden Mikrobiomveränderungen durch eine gezielte Darmtherapie behandelt werden.Reaktivierung latenter Viren durch SARS-CoV-2-InfektionAktuelle Studien weisen darauf hin, dass eine Infektion mit SARS-CoV-2 zu einer Reaktivierung latenter Viren führen kann. Dazu gehören v. a. der Epstein-Barr-Virus (EBV) oder humane Herpesviren[19]. Mit dem EBV infizieren sich 90-95 % der Menschen, die meisten davon bereits im Kindesalter.…”