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Published on: June 5, 2021
Positive Epstein-Barr virus detection in coronavirus disease 2019 (COVID-19) patients
Ting Chen1, Jiayi Song1, Hongli Liu1
1Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China.
Insights
Epstein-Barr virus (EBV) coinfection is common in COVID-19 patients, increasing fever risk and inflammation. This EBV/SARS-CoV-2 coinfection may indicate more severe COVID-19 illness.
Area of Science:
- Infectious Diseases
- Virology
- Immunology
Background:
- The emergence of coronavirus disease 2019 (COVID-19) has raised concerns about potential coinfections.
- Epstein-Barr virus (EBV), a common human herpesvirus, can reactivate during other viral infections.
- Understanding EBV coinfection in COVID-19 is crucial for assessing disease severity and management.
Purpose of the Study:
- To investigate the prevalence of Epstein-Barr virus (EBV) coinfection among patients with COVID-19.
- To compare the clinical characteristics of COVID-19 patients with and without EBV coinfection.
- To determine the association between EBV coinfection and COVID-19 severity.
Main Methods:
- Retrospective single-center study of 67 COVID-19 patients.
- Classification into EBV/SARS-CoV-2 coinfection and SARS-CoV-2 alone groups based on serological results.
- Comparison of clinical features, laboratory markers (CRP, AST), and treatment (corticosteroids) between groups.
Main Results:
- High incidence of EBV coinfection observed in 55.2% of COVID-19 patients (EBV VCA IgM positive).
- EBV/SARS-CoV-2 coinfection was significantly associated with a higher risk of fever (3.09-fold increase).
- Coinfected patients showed elevated C-reactive protein (CRP) and aspartate aminotransferase (AST) levels, and increased corticosteroid use.
Conclusions:
- Epstein-Barr virus coinfection is highly prevalent in COVID-19 patients.
- EBV/SARS-CoV-2 coinfection is linked to increased fever, inflammation, and potentially more severe disease.
- EBV reactivation may play a role in the pathogenesis and severity of COVID-19.
Abstract:
The objective of this study was to detect the Epstein-Barr virus (EBV) coinfection in coronavirus disease 2019 (COVID-19). In this retrospective single-center study, we included 67 COVID-19 patients with onset time within 2 weeks in Renmin Hospital of Wuhan University from January 9 to February 29, 2020. Patients were divided into EBV/SARS-CoV-2 coinfection group and SARS-CoV-2 infection alone group according to the serological results of EBV, and the characteristics differences between the two groups were compared. The median age was 37 years, with 35 (52.2%) females. Among these COVID-19 patients, thirty-seven (55.2%) patients were seropositive for EBV viral capsid antigen (VCA) IgM antibody. EBV/SARS-CoV-2 coinfection patients had a 3.09-fold risk of having a fever symptom than SARS-CoV-2 infection alone patients (95% CI 1.11-8.56; P = 0.03). C-reactive protein (CRP) (P = 0.02) and the aspartate aminotransferase (AST) (P = 0.04) in EBV/SARS-CoV-2 coinfection patients were higher than that in SARS-CoV-2 infection alone patients. EBV/SARS-CoV-2 coinfection patients had a higher portion of corticosteroid use than the SARS-CoV-2 infection alone patients (P = 0.03). We find a high incidence of EBV coinfection in COVID-19 patients. EBV/SARS-CoV-2 coinfection was associated with fever and increased inflammation. EBV reactivation may associated with the severity of COVID-19.
