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Chronic viral coinfections differentially affect the likelihood of developing long COVID.


ABSTRACT: BACKGROUNDThe presence and reactivation of chronic viral infections, such as EBV, CMV, and HIV, have been proposed as potential contributors to long COVID (LC), but studies in well-characterized postacute cohorts of individuals with COVID-19 over a longer time course consistent with current case definitions of LC are limited.METHODSIn a cohort of 280 adults with prior SARS-CoV-2 infection, we assessed the presence and types of LC symptoms and prior medical history (including COVID-19 history and HIV status) and performed serological testing for EBV and CMV using a commercial laboratory. We used covariate-adjusted binary logistic regression models to identify independent associations between variables and LC symptoms.RESULTSWe observed that LC symptoms, such as fatigue and neurocognitive dysfunction, at a median of 4 months following initial diagnosis were independently associated with serological evidence suggesting recent EBV reactivation (early antigen-diffuse IgG positivity) or high nuclear antigen (EBNA) IgG levels but not with ongoing EBV viremia. Serological evidence suggesting recent EBV reactivation (early antigen-diffuse IgG positivity) was most strongly associated with fatigue (OR = 2.12). Underlying HIV infection was also independently associated with neurocognitive LC (OR = 2.5). Interestingly, participants who had serologic evidence of prior CMV infection were less likely to develop neurocognitive LC (OR = 0.52).CONCLUSIONOverall, these findings suggest differential effects of chronic viral coinfections on the likelihood of developing LC and association with distinct syndromic patterns. Further assessment during the acute phase of COVID-19 is warranted.TRIAL REGISTRATIONLong-term Impact of Infection with Novel Coronavirus; ClinicalTrials.gov NCT04362150.FUNDINGThis work was supported by NIH/National Institute of Allergy and Infectious Diseases grants (3R01AI141003-03S1, R01AI158013, and K24AI145806); the Zuckerberg San Francisco General Hospital Department of Medicine and Division of HIV, Infectious Diseases, and Global Medicine; and the UCSF-Bay Area Center for AIDS Research (P30-AI027763).

SUBMITTER: Peluso MJ 

PROVIDER: S-EPMC9888380 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Chronic viral coinfections differentially affect the likelihood of developing long COVID.

Peluso Michael J MJ   Deveau Tyler-Marie TM   Munter Sadie E SE   Ryder Dylan D   Buck Amanda A   Beck-Engeser Gabriele G   Chan Fay F   Lu Scott S   Goldberg Sarah A SA   Hoh Rebecca R   Tai Viva V   Torres Leonel L   Iyer Nikita S NS   Deswal Monika M   Ngo Lynn H LH   Buitrago Melissa M   Rodriguez Antonio A   Chen Jessica Y JY   Yee Brandon C BC   Chenna Ahmed A   Winslow John W JW   Petropoulos Christos J CJ   Deitchman Amelia N AN   Hellmuth Joanna J   Spinelli Matthew A MA   Durstenfeld Matthew S MS   Hsue Priscilla Y PY   Kelly J Daniel JD   Martin Jeffrey N JN   Deeks Steven G SG   Hunt Peter W PW   Henrich Timothy J TJ  

The Journal of clinical investigation 20230201 3


BACKGROUNDThe presence and reactivation of chronic viral infections, such as EBV, CMV, and HIV, have been proposed as potential contributors to long COVID (LC), but studies in well-characterized postacute cohorts of individuals with COVID-19 over a longer time course consistent with current case definitions of LC are limited.METHODSIn a cohort of 280 adults with prior SARS-CoV-2 infection, we assessed the presence and types of LC symptoms and prior medical history (including COVID-19 history and  ...[more]

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