Epstein-Barr Virus Reactivation May Be the Cause of Long COVID Symptoms

AHA Publisher — Thu, 24 Jun 2021 07:00:54 +0000

World Organization via News-Medical – 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 — that occur in approximately 30% of patients after recovery from initial COVID-19 infection. The first evidence linking EBV reactivation to long COVID, as well as an analysis of long COVID prevalence, is outlined in a new long COVID study published in the journal Pathogens. “We 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. The majority of those with long COVID symptoms were positive for EBV reactivation, yet only 10% of controls indicated reactivation.” Jeffrey E. Gold, Lead Study Author, World Organization The researchers began by surveying 185 randomly selected patients 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 researchers then found, in a subset of 68 COVID-19 patients randomly selected from those surveyed, that 66.7% of long COVID subjects versus 10% of controls were positive for EBV reactivation based on positive EBV early antigen-diffuse (EA-D) IgG or EBV viral capsid antigen (VCA) IgM titers. The difference was significant (p < 0.001, Fisher’s exact test). “We 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,” said coauthor David J. Hurley, PhD, a professor and molecular microbiologist at the University of Georgia. “This indicated to us that EBV reactivation likely occurs simultaneously or soon after COVID-19 infection.” The relationship between SARS-CoV-2 and EBV reactivation described in this study opens up new possibilities for long COVID diagnosis and treatment. The researchers indicated that it may be prudent to test patients newly positive for COVID-19 for evidence of EBV reactivation indicated by positive EBV EA-D IgG, EBV VCA IgM, or serum EBV DNA tests. 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,” said Lawrence S. Young, PhD, a virologist at the University of Warwick, and Editor-in-Chief of Pathogens. “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-herpesvirus agents such as ganciclovir.” To read the original article click here.

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A New Sign of COVID-19: A Rash in the Mouth

AHA Publisher — Tue, 28 Jul 2020 07:00:43 +0000

Angela Betsaida B. Laguipo, BSN via News-Medical Net – The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has wreaked havoc across the globe, with more than 14.89 million people infected. Coronavirus disease (COVID-19), caused by SARS-CoV-2, has a string of symptoms that include cough, fever, and difficulty of breathing. As the disease evolved, many patients reported the loss of smell and taste as other accompanying symptoms. Now, a new study reveals that the novel coronavirus may also trigger the appearance of a rash inside the mouth. A handful of patients in Spain has manifested rash-like lesions inside their mouths, baffling doctors if these could be included in the list of potential symptoms tied to SARS-CoV-2 infection. The study, conducted by the researchers at Ramon y Cajal University Hospital in Madrid, describes a potential addition to the list of signs and symptoms exhibited by patients infected with the novel coronavirus. The study is published in the journal JAMA Dermatology. COVID-19 Symptoms The U.S. Centers for Disease Control and Prevention (CDC) first listed that the signs and symptoms of COVID-19 disease include fever, cough, aches, and difficulty of breathing. Loss of smell, loss of taste, sore throat, and headaches were added to that list later. In June, the CDC also included other symptoms that were seen in COVID-19 patients, including nausea, diarrhea, and runny nose. However, in April, a separate group of researchers in Spain found lesions on the feet of patients, which were also tied to the novel coronavirus infection. The Study To arrive at the findings in this new study, the researchers examined 21 consecutive patients that had presented with both a skin rash and COVID-19 at the Ramon y Cajal University Hospital in Madrid between March 30 and April 8. The team aimed to determine whether the patients developed the enamthem, a term used to describe the lesions on mucous membranes, inside their mouths. The oral cavities of the patients who had the enamthems were systematically examined and categorized into four groups – petechial, macular, macular with petechiae, or erythematovesicular. In the studied group, enamthems or skin rash-like lesions inside the mouths were seen in six of 21 patients with COVID-19, who were between the ages of 40 and 69 years old. Of these, four of the six affected patients were females. The researchers noted in the study that many cases of enamthems were tied to viral infections. These lesions may present with petechia, macules, vesicles, and papules in the mouth. However, the most common ones tied to viral infections are erythemato-vesicular and petechial patterns. Further, these lesions are commonly seen in adults. The team also reported that these lesions were unlikely to be a drug side effect, but more linked to the infection itself. Also, the team said that due to concerns on the safety of healthcare workers and clinicians, many patients suspected to have the SARS-CoV-2 infection or are known to be infected, do not have their mouths examined. The new symptom is now added to the list of symptoms found in patients today. “This work describes preliminary observations and is limited by the small number of cases and the absence of a control group. Despite the increasing reports of skin rashes in patients with COVID-19, establishing an etiological diagnosis is challenging. However, the presence of enanthem is a strong clue that suggests a viral etiology rather than a drug reaction, especially when a petechial pattern is observed,” the team concluded in the study. Global Coronavirus Toll As the disease evolves and spreads across the globe, much information about the virus is being revealed and discovered. The virus is still actively spreading, with the global case toll topping 14.89 million. The death toll has now reached 615,000. The United States reports the highest number of infections, with 3.89 million confirmed cases, followed by Brazil, whose case toll has doubled in the past weeks, reaching 2.15 million. India has reported 1.15 million confirmed cases, while Russia has more than 782,000 cases. One of the major concerns of the World Health Organization (WHO) is the spread of the virus in South Africa due to concerns that the high infection rate may take a toll on the nation’s health system. The country has more than 381,000 infections. This article has been modified. To read the original article click here.

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Epstein-Barr Virus Reactivation May Be the Cause of Long COVID Symptoms

A New Sign of COVID-19: A Rash in the Mouth