Long COVID: Epstein-Barr virus may offer clues

More than 95% of healthy adults have a “latent” or dormant infection of the Epstein-Barr virus (EBV), a type of herpes virus.

Illness and other stressors can reactivate the infection.

Two very small recent studies have suggested reasons to explore the relationship between reactivation of the infection and the severity of both long COVID and COVID-19.

If more extensive studies support the role of EBV reactivation in long COVID, antiviral drugs that work against herpes viruses may help prevent or treat the condition.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7896197/" rel="noopener noreferrer - Around a thirdTrusted Source of people who have had COVID-19 experience symptoms lasting 12 weeks or more, including fatigue, “brain fog,” and skin rashes, collectively known as long COVID.

Other symptoms include difficulty sleeping, joint and muscle pain, sore throat, headaches, and fever.

Individuals can develop long COVID regardless of whether their initial infection with SARS-CoV-2 — the virus that causes COVID-19 — was symptom-free, mild, or severe.

Two small studies examined the role of the reactivation of another virus in long COVID and more severe cases of COVID-19. 

This other infection is https://www.cdc.gov/epstein-barr/about-ebv.html" rel="noopener noreferrer - EBVTrusted Source , a type of herpes virus that can cause glandular fever, which shares many symptoms with long COVID. At least 95% of adults have a “latent” or dormant EBV infection that causes no symptoms.

As below, the results of the two studies are limited, but further investigation is warranted.

The first study

In the first study, doctors at http://www.rmhospital.com/ENFR/EN/index.html" rel="noopener noreferrer - Renmin Hospital of Wuhan University in Wuhan, China, looked at 67 hospitalized people who had both confirmed COVID-19 and an EBV test that their doctor ordered. 

It is important to note that most of the patients initially eligible for the study did not undergo an ordered EBV test, so it might be that there was something different about these 67 individuals that led to this recommended screening. 

Nevertheless, of those 67 people, around 55% were confirmed as having a reactivated EBV infection.

They found that these patients were more likely to report having experienced fever, although neither group of patients had a measured elevated temperature in the hospital. No other symptoms or vital signs differed between the groups. 

The authors did find a higher level of an inflammatory marker called CRP in the EBV group, but in both groups, the levels were within the normal healthy range. The cases were mostly mild in both groups, and the EBV group did not need more oxygen, increased access to ICU care, or longer recovery time.

Their study appears in the journal https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8149409/" rel="noopener noreferrer - Scientific ReportsTrusted Source . 

Long COVID

In the second small study, researchers at universities in the United States and Turkey found that around a third of 185 randomly surveyed COVID-19 patients had symptoms at least 30 days after testing positive.

When the scientists tested blood samples from some participants, they discovered that 66.7% (20 out of 30) of those with long COVID had a reactivated EBV infection.

By contrast, only 10% (2 out of 20) of those who did not develop long COVID were positive for EBV reactivation.

All 185 people in this group tested positive for COVID-19 more than 90 days before undergoing blood tests.

The scientists also analyzed the blood of a second group of 18 patients 21–90 days after testing positive for SARS-CoV-2. This revealed a similar ratio between those with long COVID who had a reactivated EBV infection and those who did not.

The researchers say this suggests that reactivation occurred soon after or concurrently with contraction of the SARS-CoV-2 infection. 

They conclude that infection with SARS-CoV-2 may reactivate EBV, which in turn may cause many long COVID symptoms. 

This study, led by the research charity https://world.org/" rel="noopener noreferrer - World Organization , appears in the journal https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233978/" rel="noopener noreferrer - PathogensTrusted Source . 

The authors write:

“These findings suggest that many long COVID symptoms may not be a direct result of the SARS-CoV-2 virus but may be the result of COVID-19 inflammation-induced EBV reactivation.”

I remember about 15 years ago, a co-worker had MRSA.  He had first had MRSA a few months previously, and now it had come back.  He was told by his doctor that all kinds of bugs can seem to go away, but they are really just lying dormant in the body, and can be reactivated by stress, poor nutrition, even lifestyle changes and (my PA told me) bad gut biome.  I have frequently wondered if some of these people who got Covid "again" were just harboring it in their bodies, and it reactivated.

That's a very interesting post about EBV Techno, thanks. I had my family tested for it last year and 3 out of 4 of us had it in our systems. I then had us treated to get rid of it. It took 3 cycles for both me and my eldest son but we're all clear of it now and I've had that verified not only by the alternative medicine practitioner who treated us but independently with blood tests from our doctor. We're booked to go back and get rechecked for nasties once a year hereafter.

Great article 👍

Very interesting.....

Wonders if this is why 

Some get C19 and are really sick while others die.....

IE,dormant nasties reactivated by C19.....

Take care all 😷😉

[url]https://spondylitis.org/spondylitis-plus/why-fatigue-plagues-so-many-with-spondyloarthritis-a-conversation-with-leading-researcher-and-spondyloarthritis-warrior-dr-mechiel-korte/[/url] or https://spondylitis.org/spondylitis-plus/why-fatigue-plagues-so-many-with-spondyloarthritis-a-conversation-with-leading-researcher-and-spondyloarthritis-warrior-dr-mechiel-korte/ - https://spondylitis.org/spondylitis-plus/why-fatigue-plagues-so-many-with-spondyloarthritis-a-conversation-with-leading-researcher-and-spondyloarthritis-warrior-dr-mechiel-korte/ ;

How and why does fatigue occur in spondyloarthritis? What are the processes, chemical changes, and functions that produce the severe fatigue seen in spondyloarthritis?  

First, the causes of fatigue: Spondyloarthritis is characterized by inflammation. During the inflammatory process many immune cells are activated, and these cells release inflammatory substances (also called cytokines, such as IL-1, IL-6 and TNF-alpha). These substances affect brain functioning via different routes. As a result, the balance of signaling substances (neurotransmitters) in the brain changes. For instance, decreased concentrations of dopamine and serotonin can be observed in specific brain areas that are involved in the regulation of motivation, reward, cognition, and more.  

Second, the processes that produce fatigue: Although more research is needed, we can speculate that lower dopamine and serotonin levels in the brain increase fatigue.  

Dopamine produces a motivational signal in the brain. It invigorates and energizes you toward a distinct goal. Thus, when there is more inflammation in SpA and consequently lower dopamine levels in the brain, one is not energized to do things that normally produce pleasure, like going to a movie or restaurant. 

Serotonin in the brain is involved in the regulation of many behaviors, because it plays a crucial role in reward-cost valuation. As inflammation lowers serotonin levels in the brain, a signal is sent that behavioral actions have higher energy costs than they normally do, therefore causing the person to abstain from activities to conserve energy. Recently, it became clear that serotonin can directly influence neuronal powerplants (mitochondria) that produce energy in cells, including brain cells. Again, lower serotonin levels give a signal that there is less energy available, which might suppress normal social behavior. 

Third, why is fatigue so prevalent: Without a doubt, this is the most difficult question. Normally, illness, including fever and fatigue brought on by infection with a virus or bacteria, can be functional (that is to say, they have an evolutionary or biological benefit). The lower serotonin and dopamine levels produce a feeling of fatigue, and because less energy is available, one is no longer energized or motivated to do things. Consequently, you withdraw socially so that A) you do not infect other group members, and B) you save your energy to fight the infection and to recover. This is functional and subsides when you recover from an infection. But inflammation in SpA is often a chronic process, so consequently, we often suffer from chronic fatigue. Remarkably, people with SpA who suffer from fatigue seem to have a biological advantage right now because they do not have the energy to be socially active and so they tend to be less exposed as a result. (On a side note, one of the problems in this pandemic is that COVID-19 does not always produce these typical sickness symptoms, such as fever or fatigue, in everyone, so infected people are sometimes still energized and motivated to do things and be socially active, meanwhile spreading the disease.)  

Speaking of COVID-19, with the pandemic encircling the globe everything seems to be different. Are you concerned for your safety? What would you like to share about this health crisis with our readers?  

There is always a question in the back of my mind of, “What if?” I am not a medical doctor but a neuroscientist who investigates immune-brain interactions, including the role of stress. Uncertainty and unpredictability are known to produce stress. Long-term stress is bad for the immune system. So, it is important to control stress levels. The best way to prevent stress is to focus on what you can do. What can we do? Honestly, together we can do so many things.  

First, trust the medical experts, follow their advice, and ask questions when you need answers.  

Second, the virus does not have legs or wings; it is just dead material. This means that the virus can only spread with the help of people.

DJ-Inflamation=cytokines=also effecting the brain ?