In a new study from World Organization and elsewhere, researchers found that Epstein-Barr virus (EBV) reactivation resulting from the inflammatory response to coronavirus infection may be the cause of previously unexplained long COVID symptoms—such as fatigue, brain fog, and rashes.
The long COVID symptoms occur in approximately 30% of patients after recovery from initial COVID-19 infection.
In the study, the team surveyed 185 randomly selected patients who recovered from COVID-19 and found that 30.3% had long-term symptoms consistent with long COVID after initial recovery from SARS-CoV-2 infection.
This included several patients with initially asymptomatic COVID-19 cases who later went on to develop long COVID symptoms.
The team then ran EBV antibody tests on recovered COVID-19 patients, comparing EBV reactivation rates of those with long COVID symptoms to those without long COVID symptoms
They found that 66.7% of long COVID subjects versus 10% of controls were positive for EBV reactivation.
They found similar rates of EBV reactivation in those who had long COVID symptoms for months, as in those with long COVID symptoms that began just weeks after testing positive for COVID-19.
This indicated that EBV reactivation likely occurs simultaneously or soon after COVID-19 infection.
The researchers indicated that it may be prudent to test patients newly positive for COVID-19 for evidence of EBV reactivation.
If patients show signs of EBV reactivation, they can be treated early to reduce the intensity and duration of EBV replication, which may help inhibit the development of long COVID.
As evidence mounts supporting a role for EBV reactivation in the clinical manifestation of acute COVID-19, this study further implicates EBV in the development of long COVID.
If a direct role for EBV reactivation in long COVID is supported by further studies, this would provide opportunities to improve the rational diagnosis of this condition and to consider the therapeutic value of anti-herpes virus drugs.
The study is published in the journal Pathogens. One author of the study is Jeffrey E. Gold.
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