Chronic viral coinfections differentially affect the likelihood of developing long COVID

作者：Michael J. Peluso, Tyler‐Marie Deveau, Sadie E. Munter, Dylan Ryder, Amanda M. Buck, Gabriele Beck‐Engeser, Fay Chan, Scott Lu, Sarah A. Goldberg, Rebecca A. Hoh, Viva Tai, Leonel Torres, Nikita S. Iyer, Monika Deswal, Lynn H. Ngo, Melissa Buitrago, Antonio Rodríguez, Jessica Y. Chen, Brandon C. Yee, Ahmed Chenna, John William Winslow, Christos J. Petropoulos, Amelia N. Deitchman, Joanna M. Hellmuth, Matthew A. Spinelli, Matthew S. Durstenfeld, Priscilla Y. Hsue, John Daniel Kelly, Jeffrey N. Martin, Steven G. Deeks, Peter W. Hunt, Timothy J. Henrich · 发表于：Journal of Clinical Investigation · 年份：2022 · DOI：10.1172/jci163669 · 被引用次数：229 · 研究领域：Long-Term Effects of COVID-19、COVID-19 Clinical Research Studies、Inflammasome and immune disorders

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 different...