Herpesvirus infections and post-COVID-19 manifestations: a pilot observational study

• Published in: Rheumatology international Vol. 42; no. 9; pp. 1523 - 1530
• Main Authors: Zubchenko, Svitlana, Kril, Iryna, Nadizhko, Olena, Matsyura, Oksana, Chopyak, Valentyna
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2022; Springer Nature B.V
• Subjects: Adult; Coronaviruses; COVID-19; COVID-19 - complications; Cytomegalovirus Infections; Female; Herpes viruses; Herpesviridae; Herpesviridae Infections; Herpesvirus 4, Human; Humans; Infections; Long COVID; Male; Medicine; Medicine & Public Health; Middle Aged; Observational Research; Observational studies; Rheumatology; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; COVID-19; Herpes virus; Epstein–Barr virus; An autoimmune disease; Rheumatology
• ISSN: 1437-160X; 0172-8172; 1437-160X
• DOI: 10.1007/s00296-022-05146-9

The global spread of SARS-CoV-2 points to unrivaled mutational variation of the virus, contributing to a variety of post-COVID sequelae in immunocompromised subjects and high mortality. Numerous studies have reported the reactivation of "sluggish" herpes virus infections in COVID-19, which exaggerate the course of the disease and complicate with lasting post-COVID manifestations CMV, EBV, HHV6). This study aimed to describe clinical and laboratory features of post-COVID manifestations accompanied by the reactivation of herpes virus infections (CMV, EBV, HHV6). 88 patients were recruited for this study, including subjects with reactivation of herpes viruses, 68 (72.3%) (main group) and 20 (27.7%) subjects without detectable DNA of herpesviruses (control group): 46 (52.3%) female and 42 (47.7%) male; median age was 41.4 ± 6.7 years. Patients with post-COVID manifestations presented with reactivation of EBV in 42.6%, HHV6 in 25.0%, and EBV plus HHV6 in 32.4%. Compared with controls, patients with herpes virus infections presented with more frequent slight fever temperature, headache, psycho-neurological disorders, pulmonary abnormalities and myalgia ( p  < 0.01), activation of liver enzymes, elevated CRP and D-dimer, and suppressed cellular immune response ( p  ≤ 0.05). Preliminary results indicate a likely involvement of reactivated herpes virus infections, primarily EBV infections in severe COVID-19 and the formation of the post-COVID syndrome. Patients with the post-COVID syndrome and reactivation of EBV and HHV6 infections are at high risk of developing various pathologies, including rheumatologic diseases.