Long-COVID or Re-activation of EBV?

The prevalence of ‘long-COVID’ is surprisingly high, around 30% of infections go on to produce long-term symptoms after resolution of the acute infection. And severity of initial infection does not determine the likelihood of developing Long-COVID.

– or re-activation of EBV?

Was it perhaps the similarity of presenting symptoms that prompted researchers to investigate the overlap incidence between Long-COVID and Epstein Barr Virus (EBV)?

The primary infection of EBV mostly occurs in childhood and is so mild as to be asymptomatic. As a result over 90% of UK adults are seropositive. However, some cases in adulthood present as ‘infectious mononucleosis’ (glandular fever). The virus stays latent within the body’s lymphocyte B cells for life, effectively in a dormant state.  But dormant infections can become re-activated from stress and other illnesses, or if the immune system becomes weakened.  Symptoms of EBV re-activation include fatigue, insomnia, myalgia, confusion/brain fog, headache, weakness, tinnitus, fever, inflammation and skin manifestations of rashes and Raynauds syndrome, regardless of when you first acquired EBV virus.

Current Research

A published study (June 2021 Pathogens) that recruited 68 Long-COVID patients from 185 randomly surveyed COVID-19 patients, found 66.7% of them were positive for re-activated EBV, compared to just 10% of the control group. Three analyses were performed to ascertain the presence of EBV: IgM and IgG antibodies, as well as a PCR test looking for serum circulating DNA of EBV. You can read more about the study here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233978/

If more studies support the role of EBV re-activation in Long-COVID patients, perhaps anti-viral drugs that work against the other herpes viruses may help to treat the condition.

The good news is that research is taking Long-COVID seriously, in a way that Chronic Fatigue Syndrome and ME could only dream about for decades.  Around 90 Long-COVID clinics have been set up around the country, and around 5,000 people a month are being referred in to them, read more about it here on the NIHR website:

https://www.nihr.ac.uk/covid-19/researching-the-long-term-impact.htm