Epstein-Barr Virus Reactivation May Lead to Long-Covid

About one-third of patients who get infected with the SARS-CoV-2 virus are susceptible to long-term symptoms of the resulting coronavirus disease 2019 (COVID-19) after their acute symptoms have subsided. Long-COVID diagnosis and management has remained a struggle, but researchers are finding new data that can help identify the right treatment options.

Waking Up a Dormant Virus

The Epstein-Barr virus (EBV), from the gamma herpesvirus family, typically infects individuals and then becomes dormant in 90% of the world’s population. The virus can remain dormant for years in your body and can reactivate in some cases. Symptoms may be seen in individuals with a weaker immune system. Young children may be asymptomatic when first infected with the virus, but in adolescents or adults the first infection with EBV can lead to infectious mononucleosis. EBV has been shown in the past to cause chronic infections or to reactivate infections.

Several new studies have identified a strong association between patients who carry EBV and long COVID symptoms. One of the studies found that long-COVID patients (90 days post–COVID-19 diagnosis) were much more likely (~6.5-times) to have EBV activation than those without COVID-19. A similar trend was also observed in short-term COVID-19 (21-90 days post diagnosis) patients. 

The most common symptoms in patients who had EBV reactivation and either long-COVID or short-term COVID, were:

  • Fatigue
  • Insomnia
  • Headaches
  • Myalgia/muscle pain
  • Confusion

Other symptoms included hearing loss and skin rashes.

Another hypothesis being drawn is that a different virus may trigger EBV, which in turn may trigger chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME). Considering the similar symptoms between CFS and long COVID, they might even be the same disease. 

Reassessing Treatment Options for Long COVID Patients With EBV

Identifying this connection between EBV and long COVID means physicians now have other options for the management of long COVID symptoms and should start thinking about other treatment options, such as anti-EBV drugs in the treatment plan.

Surabhi Dangi-Garimella, Ph.D. is a biologist with academic research experience, who brings her skills and knowledge to the health care communications world. She provides writing and strategic support to non-profit groups via her consultancy, SDG AdvoHealth, LLC.

Surabhi Dangi Garamella

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