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Could EBV Reactivation Help Explain The Prevalence Of Long COVID?

At the time of writing, over 332 million people across the globe have contracted COVID-19, and the death toll from the virus sits at just over 5.5 million. Many people who have had COVID-19 and recovered from it are still dealing with the aftermath of the infection. Lasting symptoms and other health complications have begun developing in many people – so many that the phenomenon has earned the name “long COVID” or “post-COVID-19 syndrome”.

The typical symptoms of a COVID-19 infection can linger for months after the infection has cleared in many people, and in some cases, the infection has led to organ damage, blood clots and blood vessel issues, mood and fatigue disorders, and even a condition known as Guillain-Barre syndrome that causes temporary paralysis. With so many ailments and conditions arising after a COVID-19 infection, new research is investigating whether the reactivation of the Epstein-Barr virus (EBV) could also be added to the list. Read on for more information about reactivation of EBV after COVID.

Epstein-Barr and COVID-19

EBV is a viral infection, and so is COVID-19. However, the two are not caused by the same family of viruses. As many people know, COVID-19 belongs to the coronavirus family, while EBV belongs to the herpesvirus family. Epstein-Barr virus is one of the most prevalent viral infections in humans, with research suggesting that as many as 90% of people become infected with the virus at some point in their lives. Often, there are no symptoms of note when a person becomes infected, which may be why the virus has spread so easily among the worldwide population. 

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Image by Annie Spratt on Unsplash: What do reactivated Epstein-Barr virus symptoms feel like?

This is in clear contrast to COVID-19, with the majority of people experiencing, at the very least, mild symptoms. According to research, only about 17% of people who contract COVID-19 experience no symptoms at all. The symptoms of EBV and COVID-19 can be similar, however, potentially making it difficult to distinguish between COVID-19 and a reactivation of EBV.  

While the two viruses may present differently in many ways, there are still some things that researchers aren’t yet clear on. For example, EBV remains dormant in a person’s system for life, but can reactivate at any time. Data suggesting any similar behavior in COVID-19 is not yet available due to the newness of the disease.

Can COVID trigger Epstein-Barr reactivation?

While the research surrounding the triggering of EBV by a COVID-19 infection is still ongoing, there has been some clinical evidence to support that getting infected with COVID-19 may actually reactivate EBV. The theory is that an EBV reactivation during a COVID infection may actually cause worsened health complications because the body is busy trying to fight off both infections at the same time, even though it has already been living with EBV for a period of time.

One particular study looked at a small sample group of 67 people with COVID-19 infections, testing them for EBV. Just over half of the participants were diagnosed with EBV on top of their COVID-19 infection. Both groups, however, presented with similar symptoms that were nearly indistinguishable.

The EBV group did have higher levels of a specific anti-inflammatory marker; however, both groups had healthy levels of the marker. Both groups had similar recovery times, similar need for oxygen, and similar ICU care, and there was no discernable difference in the severity of the infection.

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Image by engin akyurt on Unsplash: Is there a connection between long COVID and EBV?

Long COVID and EBV

When looking at long COVID and EBV, other studies have investigated whether or not there is a connection between the lingering symptoms of COVID-19 and a previous EBV infection. One particular study looked at 185 randomly surveyed patients with COVID-19 and found that 66.7% of those surveyed had long COVID symptoms with a reactivation of EBV.

That being said, 10% of the people surveyed were positive for EBV without the associated long COVID symptoms. The results of the study suggest that people who contract COVID-19 and already have the EBV infection may experience an EBV reactivation while they are infected with COVID-19 or shortly after. It is also thought that a reactivation of EBV after COVID could be the driver behind long COVID symptoms in many people.

The hypothesis surrounding the reactivation of EBV and its association with long COVID could be due to how the COVID-19 infection targets specific cells in the mouth, throat, and nose. Since EBV typically replicates at a low level in those areas of the body (even without causing symptoms to develop), it’s thought that the COVID-19 virus targets cells in those areas, causing the EBV to replicate in higher amounts.

While research is still ongoing, the connection between these two viral infections may be helpful in the diagnosis and treatment of long COVID symptoms in the future because of the antiviral medications already in use to help fight off herpesviruses.

Featured image by Towfiqu barbhuiya on Unsplash

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