Solomay T V, Semenenko T A, Filatov N N, Vedunova S L, Lavrov V F, Smirnova D I, Gracheva A V, Faizuloev E B
Interregional Department No. 1 of the Federal Medical and Biological Agency; FSBSI «I.I. Mechnikov Research Institute of Vaccines and Sera».
FSBI «National Research Centre for Epidemiology and Microbiology named after the honorary academician N.F. Gamaleya» of the Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University (Sechenov University).
Vopr Virusol. 2021 May 15;66(2):152-161. doi: 10.36233/0507-4088-40.
Immunodeficiency underlying the development of severe forms of new coronavirus infection may be the result of mixed infection with SARS-CoV-2 and other pathogens, including Epstein-Barr virus (EBV).The aim is to study the prevalence and epidemiological features of co-infection with SARS-CoV-2 and EBV.
A cross-sectional randomized study was conducted in Moscow region from March to May 2020. Two groups were examined for EBV-markers: hospital patients (n = 95) treated for SARS-CoV-2 infection and blood donors (n = 92).
With equal EBV prevalence the detection of active infection markers in donors (10.9%) was noticeably lower than in SARS-CoV-2 patients (80%). Significant differences in this indicator were also found when patients from subgroups with interstitial pneumonia with the presence (96.6%) and absence (97.2%) of SARS-CoV-2 in the nasopharyngeal smear were compared with the subgroup of patients with mild COVID-19 (43.3%). The average IgG VCA and IgG EBNA positivity coefficients in donor group were higher than in patient group (p < 0.05). Patients with active EBV infection markers were significantly more likely to have pneumonia, exceeding the reference values of ALT and the relative number of monocytes (odds ratio - 23.6; 3.5; 9.7, respectively).
The present study examined the incidence and analyzed epidemiological features of active EBV infection in patients with COVID-19.
A significantly higher rate of detection of active EBV infection markers in hospital patients indicates a combined participation SARS-CoV-2 and EBV in the development of interstitial pneumonia. Low levels of specific IgG EBV serve as predictors of EBV reactivation. Exceeding the reference values of ALT and the relative number of monocytes in patients should serve as a reason for examination for active EBV infection markers.
严重新型冠状病毒感染形式发展背后的免疫缺陷可能是由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）与其他病原体混合感染导致的，包括爱泼斯坦-巴尔病毒（EBV）。目的是研究SARS-CoV-2与EBV合并感染的患病率及流行病学特征。
2020年3月至5月在莫斯科地区进行了一项横断面随机研究。对两组进行EBV标志物检测：治疗SARS-CoV-2感染的住院患者（n = 95）和献血者（n = 92）。
EBV患病率相同，但献血者中活动性感染标志物的检出率（10.9%）明显低于SARS-CoV-2患者（80%）。当比较鼻咽涂片中有（96.6%）和无（97.2%）SARS-CoV-2的间质性肺炎亚组患者与轻度新型冠状病毒肺炎（COVID-19）患者亚组（43.3%）时，该指标也存在显著差异。献血者组中平均IgG VCA和IgG EBNA阳性系数高于患者组（p < 0.05）。有活动性EBV感染标志物的患者患肺炎的可能性显著更高，其丙氨酸转氨酶（ALT）参考值和单核细胞相对数量也超过参考值（优势比分别为23.6、3.5、9.7）。
本研究调查了COVID-19患者中活动性EBV感染的发生率并分析了其流行病学特征。
住院患者中活动性EBV感染标志物的检出率显著更高，表明SARS-CoV-2和EBV共同参与了间质性肺炎的发展。EBV特异性IgG水平低是EBV重新激活的预测指标。患者ALT参考值和单核细胞相对数量超过参考值应作为检查活动性EBV感染标志物的原因。
