Epstein-Barr virus reactivation is not causative for post-COVID-19-syndrome in individuals with asymptomatic or mild SARS-CoV-2 disease course
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Published:2023-11-15
Issue:1
Volume:23
Page:
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ISSN:1471-2334
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Container-title:BMC Infectious Diseases
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language:en
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Short-container-title:BMC Infect Dis
Author:
Hoeggerl Alexandra Domnica, Nunhofer Verena, Lauth Wanda, Badstuber Natalie, Held Nina, Zimmermann GeorgORCID, Grabmer Christoph, Weidner Lisa, Jungbauer Christof, Lindlbauer Nadja, Neureiter Heidrun, Ortner TuuliaORCID, Flamm Maria, Osterbrink Jürgen, Rohde EvaORCID, Laner-Plamberger SandraORCID
Abstract
Abstract
Purpose
Post-COVID-19-Syndrome (PCS) frequently occurs after an infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). However, the understanding of causative mechanisms is still limited. Aim of this study was to determine the PCS rate among SARS-CoV-2 seropositive blood donors as representatives of supposedly healthy adults, who had experienced an asymptomatic or mild COVID-19 disease course, and to examine whether Epstein-Barr virus (EBV) is reactivated in individuals reporting PCS.
Methods
The PCS rate was determined using questionnaires that included questions about infection and persistent symptoms. Pre-pandemic blood samples and samples collected at regular, pre-defined times after a SARS-CoV-2 infection were analysed for neopterin, a marker for antiviral immune responses, by an enzyme-linked immunosorbent assay (ELISA). Additionally, we determined the rate of SARS-CoV-2 anti-N total antibodies using an electrochemiluminescence immunoassay (ECLIA). Furthermore, quantitative real-time polymerase chain reaction (qPCR) to detect EBV DNA and ECLIA screening for EBV viral capsid-antigen (VCA) IgM, IgG and EBV nuclear antigen 1 (EBNA) IgG were performed.
Results
Our data reveal that 18% of all infections result in PCS, with symptoms lasting for up to one year. In individuals reporting PCS, no elevated levels of neopterin were detected, indicating no persisting pro-inflammatory, antiviral immune response. SARS-CoV-2 antibody levels were declining in all participants in comparable manner over time, pointing to a successful virus clearance. In individuals with PCS, no EBV DNA could be detected. Furthermore, no differences in EBV specific antibody levels could be shown in PCS groups compared to non-PCS groups.
Conclusion
Our data suggest that PCS in per se healthy, immunocompetent adults cannot be ascribed to a reactivation of EBV.
Funder
Salzburger Landesregierung
Publisher
Springer Science and Business Media LLC
Subject
Infectious Diseases
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