Photo credit: Jeffrey E. Gold, Ramazan A. Okyay, Warren E. Licht, and David J. Hurley

Two recently published studies, available on the National Institutes of Health (NIH) website, indicate that reactivating Epstein-Barr Virus (EBV) may be beneficial in developing long-term COVID symptoms as well as severe COVID- 19 cases can play a role.

The first evidence linking EBV reactivation to prolonged COVID symptoms was by Gold et al. (2021) and published in Pathogens. This study can be viewed on the NIH website here: https: ///www.ncbi.nlm.NIH.Government/pmc /Items/PMC8233978 /

“We performed serological tests for Epstein-Barr virus in COVID-19 patients at least 90 days after testing positive for SARS-CoV-2 infection and compared EBV reactivation rates with those with long-term COVID symptoms who have never had COVID symptoms for a long time, “said study leader Jeffrey E. Gold of the world organization. “We found that over 73% of COVID-19 patients who had long-term Covid symptoms were also positive for EBV reactivation.”

Another research group, Chen et al. (2021), found that EBV reactivation may also be linked to the severity of COVID-19. Your report published in Scientific reports of nature is available here: https: ///www.ncbi.nlm.NIH.Government/pmc /Items/PMC8149409 /

Gold says more than 95% of healthy adults test positive for latent EBV infection, which is identified by testing for the presence of EBV VCA IgG and / or EBV Nuclear Antigen 1 (EBNA-1) IgG. On the other hand, EBV reactivation is identified by further testing for the presence of EBV EA-D IgG, EBV VCA IgM, and / or circulating EBV DNA.

David J. Hurley, PhD, professor and molecular microbiologist at the University of Georgia and co-author of the Pathogens Study said, “We found similar rates of EBV reactivation in those who had long-term COVID symptoms for months to those with long-term COVID symptoms who started just weeks after testing positive for COVID-19. This showed us that the EBV reactivation probably happens at the same time or shortly after the COVID-19 infection. “

According to Gold, other diseases and stressors can also trigger EBV reactivation, and not just COVID-19. However, the inflammatory response to SARS-CoV-2 infection appears to be more successful than many other stressors in triggering EBV reactivation. While EBV reactivation may not be responsible for all cases of recurring fatigue or brain fog after recovering from COVID-19, evidence suggests that it is likely to play a role in many or even most of the cases.

The Pathogens Study found that nearly a third of 185 people surveyed who tested positive for COVID-19 ended up with long-term symptoms, even some who were originally asymptomatic. This percentage of long-term consequences after COVID-19 infection was similar to the percentage found in a separate study. Consequences in adults 6 months after COVID-19 infection, published in JAMA network open.

The relationship between SARS-CoV-2 and EBV reactivation described in these studies opens up new possibilities for the diagnosis and treatment of primary COVID-19 infections and long-term COVID. The study researchers in Pathogens indicate that it may be advisable to test patients newly tested positive for COVID-19 for signs of EBV reactivation identified by positive EBV-EA-D-IgG, EBV-VCA-IgM, or Serum EBV DNA Testing is shown. If patients show signs of EBV reactivation, they can be treated early to reduce the intensity and duration of EBV replication, which can help stunt the development of long-lasting COVID.

Although there is no available vaccine to prevent EBV infection, an open phase 1 trial will begin on July 26, 2021 to evaluate the safety and immunogenicity of an EBV vaccine sponsored by the National Institute of Allergy and Infectious Diseases (NIAID) at the NIH carried out expected to begin.

“With increasing evidence that EBV reactivation plays a role in the clinical manifestation of acute COVID-19, this study further implies EBV in the development of long-term COVID,” said Lawrence S. Young, PhD, a virologist from the University of Warwick, who has the Pathogens Study. “If further studies support a direct role for EBV reactivation in long-term COVID, it would provide opportunities to improve the rational diagnosis of this condition and to consider the therapeutic value of anti-herpesvirus agents such as ganciclovir.”

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Original publication: Gold, JE; Okay RA; Light, WE; Hurley, DJ Examining Long COVID Prevalence and Its Relationship to Epstein-Barr Virus Reactivation. Pathogens 2021, 10, 763. https: //doi.Organization/10.3390 /Pathogen 10060763

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