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Impact of pre-existing chronic viral infection and reactivation on the development of long COVID.
Peluso, Michael J; Deveau, Tyler-Marie; Munter, Sadie E; Ryder, Dylan M; Buck, Amanda M; Beck-Engeser, Gabriele; Chan, Fay; Lu, Scott; Goldberg, Sarah A; Hoh, Rebecca; Tai, Viva; Torres, Leonel; Iyer, Nikita S; Deswal, Monika; Ngo, Lynn H; Buitrago, Melissa; Rodriguez, Antonio E; Chen, Jessica Y; Yee, Brandon C; Chenna, Ahmed; Winslow, John W; Petropoulos, Christos J; Deitchman, Amelia N; Hellmuth, Joanna; Spinelli, Matthew A; Durstenfeld, Matthew S; Hsue, Priscilla Y; Kelly, John Daniel; Martin, Jeffrey N; Deeks, Steven G; Hunt, Peter W; Henrich, Timothy J.
  • Peluso MJ; Division of HIV, Infectious Diseases, and Global Medicine, UCSF, San Francisco, United States of America.
  • Deveau TM; Division of Experimental Medicine, UCSF, San Francisco, United States of America.
  • Munter SE; Division of Experimental Medicine, UCSF, San Francisco, United States of America.
  • Ryder DM; Division of Experimental Medicine, UCSF, San Francisco, United States of America.
  • Buck AM; Division of Experimental Medicine, UCSF, San Francisco, United States of America.
  • Beck-Engeser G; Division of Experimental Medicine, UCSF, San Francisco, United States of America.
  • Chan F; Division of Experimental Medicine, UCSF, San Francisco, United States of America.
  • Lu S; Department of Epidemiology and Biostatistics, UCSF, San Francisco, United States of America.
  • Goldberg SA; Department of Epidemiology and Biostatistics, UCSF, San Francisco, United States of America.
  • Hoh R; Division of HIV, Infectious Diseases, and Global Medicine, UCSF, San Francisco, United States of America.
  • Tai V; Division of HIV, Infectious Diseases, and Global Medicine, UCSF, San Francisco, United States of America.
  • Torres L; Division of Experimental Medicine, UCSF, San Francisco, United States of America.
  • Iyer NS; Division of Experimental Medicine, UCSF, San Francisco, United States of America.
  • Deswal M; Division of HIV, Infectious Diseases, and Global Medicine, UCSF, San Francisco, United States of America.
  • Ngo LH; Division of HIV, Infectious Diseases, and Global Medicine, UCSF, San Francisco, United States of America.
  • Buitrago M; Division of HIV, Infectious Diseases, and Global Medicine, UCSF, San Francisco, United States of America.
  • Rodriguez AE; Division of HIV, Infectious Diseases, and Global Medicine, UCSF, San Francisco, United States of America.
  • Chen JY; Division of HIV, Infectious Diseases, and Global Medicine, UCSF, San Francisco, United States of America.
  • Yee BC; Monogram Biosciences, South San Francisco, United States of America.
  • Chenna A; Oncology Group, Monogram Biosciences, South San Francisco, United States of America.
  • Winslow JW; Oncology Group, Monogram Biosciences, South San Francisco, United States of America.
  • Petropoulos CJ; Oncology Group, Monogram Biosciences, South San Francisco, United States of America.
  • Deitchman AN; School of Pharmacy, UCSF, San Francisco, United States of America.
  • Hellmuth J; UCSF, San Francisco, United States of America.
  • Spinelli MA; Division of HIV, Infectious Diseases, and Global Medicine, UCSF, San Francisco, United States of America.
  • Durstenfeld MS; Division of Cardiology, UCSF, San Francisco, United States of America.
  • Hsue PY; Division of Cardiology, UCSF, San Francisco, United States of America.
  • Kelly JD; Department of Epidemiology and Biostatistics, UCSF, San Francisco, United States of America.
  • Martin JN; Department of Epidemiology and Biostatistics, UCSF, San Francisco, United States of America.
  • Deeks SG; Division of HIV, Infectious Diseases, and Global Medicine, UCSF, San Francisco, United States of America.
  • Hunt PW; Division of Experimental Medicine, UCSF, San Francisco, United States of America.
  • Henrich TJ; Division of Experimental Medicine, UCSF, San Francisco, United States of America.
J Clin Invest ; 2022 Dec 01.
Article in English | MEDLINE | ID: covidwho-2234295
ABSTRACT

BACKGROUND:

The presence and reactivation of chronic viral infections such as Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human immunodeficiency virus (HIV) have been proposed as potential contributors to Long COVID (LC), but studies in well-characterized post-acute cohorts of individuals with COVID-19 over a longer time course consistent with current case definitions of LC are limited.

METHODS:

In 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.

RESULTS:

We observed that LC symptoms such as fatigue and neurocognitive dysfunction at a median of 4months following initial diagnosis were independently associated with serological evidence suggesting recent EBV reactivation (early antigen-D [EA-D] IgG positivity) or high nuclear antigen (EBNA) IgG levels, but not with ongoing EBV viremia. Serological evidence suggesting recent EBV reactivation (EA-D IgG) 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).

CONCLUSION:

Overall, these findings suggest differential effects of chronic viral co-infections on the likelihood of developing LC and predicted distinct syndromic patterns. Further assessment during the acute phase of COVID-19 is warranted. TRIAL REGISTRATION Long-term Impact of Infection with Novel Coronavirus (LIINC); NCT04362150FUNDING. This work was supported by the National Institute of Allergy and Infectious Diseases NIH/NIAID 3R01AI141003-03S1 to TJ Henrich, R01AI158013 to M Gandhi and M Spinelli, K24AI145806 to P Hunt, and by the Zuckerberg San Francisco Hospital Department of Medicine and Division of HIV, Infectious Diseases, and Global Medicine. MJP is supported on K23 A137522 and received support from the UCSFBay Area Center for AIDS Research (P30-AI027763).
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Language: English Year: 2022 Document Type: Article Affiliation country: JCI163669

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Language: English Year: 2022 Document Type: Article Affiliation country: JCI163669