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Hoeggerl AD, Nunhofer V, Lauth W, Badstuber N, Held N, Zimmermann G, Grabmer C, Weidner L, Jungbauer C, Lindlbauer N, Neureiter H, Ortner T, Flamm M, Osterbrink J, Rohde E, Laner-Plamberger S. Epstein-Barr virus reactivation is not causative for post-COVID-19-syndrome in individuals with asymptomatic or mild SARS-CoV-2 disease course. BMC Infect Dis 2023; 23:800. [PMID: 37968601 PMCID: PMC10652630 DOI: 10.1186/s12879-023-08820-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/14/2023] [Indexed: 11/17/2023] Open
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.
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Affiliation(s)
- Alexandra Domnica Hoeggerl
- Department of Transfusion Medicine, University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU) Salzburg, Müllner-Hauptstraße 48, Salzburg, 5020, Austria
| | - Verena Nunhofer
- Department of Transfusion Medicine, University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU) Salzburg, Müllner-Hauptstraße 48, Salzburg, 5020, Austria
| | - Wanda Lauth
- Team Biostatistics and Big Medical Data, IDA Lab Salzburg, PMU Salzburg, Strubergasse 16, Salzburg, 5020, Austria
- Research and Innovation Management, PMU Salzburg, Strubergasse 16, Salzburg, 5020, Austria
| | - Natalie Badstuber
- Department of Psychological Assessment, Institute of Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Nina Held
- Department of Transfusion Medicine, University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU) Salzburg, Müllner-Hauptstraße 48, Salzburg, 5020, Austria
| | - Georg Zimmermann
- Team Biostatistics and Big Medical Data, IDA Lab Salzburg, PMU Salzburg, Strubergasse 16, Salzburg, 5020, Austria
- Research and Innovation Management, PMU Salzburg, Strubergasse 16, Salzburg, 5020, Austria
| | - Christoph Grabmer
- Department of Transfusion Medicine, University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU) Salzburg, Müllner-Hauptstraße 48, Salzburg, 5020, Austria
| | - Lisa Weidner
- Austrian Red Cross, Blood Service for Vienna, Lower Austria and Burgenland, Wiedner Hauptstraße 32, Vienna, 1040, Austria
| | - Christof Jungbauer
- Austrian Red Cross, Blood Service for Vienna, Lower Austria and Burgenland, Wiedner Hauptstraße 32, Vienna, 1040, Austria
| | - Nadja Lindlbauer
- Department of Transfusion Medicine, University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU) Salzburg, Müllner-Hauptstraße 48, Salzburg, 5020, Austria
| | - Heidrun Neureiter
- Department of Transfusion Medicine, University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU) Salzburg, Müllner-Hauptstraße 48, Salzburg, 5020, Austria
| | - Tuulia Ortner
- Department of Psychological Assessment, Institute of Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Maria Flamm
- Institute of General Practice, Family Medicine and Preventive Medicine, PMU Salzburg, Strubergasse 21, Salzburg, 5020, Austria
| | - Jürgen Osterbrink
- Institute of Nursing Science and Practice, PMU Salzburg, Strubergasse 21, Salzburg, 5020, Austria
| | - Eva Rohde
- Department of Transfusion Medicine, University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU) Salzburg, Müllner-Hauptstraße 48, Salzburg, 5020, Austria
- Spinal Cord Injury and Tissue Regeneration Centre Salzburg, PMU Salzburg, Strubergasse 21, Salzburg, 5020, Austria
| | - Sandra Laner-Plamberger
- Department of Transfusion Medicine, University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU) Salzburg, Müllner-Hauptstraße 48, Salzburg, 5020, Austria.
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