Association Between EBV Reactivation & Development of Long-COVID Fatigue

The ongoing SARS-CoV-2 pandemic constitutes a major health concern worldwide. As of September 2022, over 600 million cases were reported with over 6.47 million SARS-CoV-2-related fatalities (WHO Dashboard, September 2nd, 2022). Most ongoing studies and clinical trials focus on disease prevention and treatment of acute COVID-19. However, 1-10% of previously SARS-CoV-2 positive patients develop sequelae, termed Long-COVID. Independent of the severity of acute COVID-19, symptoms often include a debilitating fatigue, post-exertional malaise, neurocognitive disorders as well as immune dysfunctions. Long-COVID fatigue partially overlaps with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Also, it is suggested that Long-COVID fatigue might evolve into ME/CFS.

We aim to translate our expertise in ME/CFS research in a Long-COVID pilot project to facilitate knowledge transfer. Our study focuses on the activity of Epstein-Barr-Virus (EBV) in Long-COVID patients. The human herpes virus has been previously suggested to be involved in the onset of ME/CFS. Thus, we hypothesize EBV reactivation to be associated with the onset of post-viral fatigue after SARS-Cov-2 infection. In our prospective study 30 Long-COVID patients and 20 convalescent COVID-19 patients were recruited. Plasma, stool and throat washing samples were collected at least 10 weeks after the COVID-19 acute phase.

Data curation and analysis is performed at the Institute of Pathophysiology and Allergy Research, Medical University of Vienna. The population of ME/CFS patients will increase and will include young adults, who experienced an asymptomatic disease course and are not aware of their infection. Data generated in our project will support medical care of currently ME/CFS affected patients, while also provide disease prevention strategies for future post-viral fatigue patients.