Epstein – Barr Virus Infection in Children Following Acute SARS-CoV-2 Infection

Abstract

BACKGROUND. Epstein–Barr virus (EBV), a human herpesvirus with potent B cell growth transforming ability, induces multiple cellular immune responses in the infected host. According to the most recent evidence, the Epstein-Barr virus is characterized by lifetime latency in B cells and intermittent recrudescence of lytic infection triggered by stresses. Furthermore, several investigations have hypothesized that autoimmune mechanisms and the persistence of SARS-CoV-2 virus fragments induce the development of long-term COVID-19. Therefore, other latent host viruses, such as Epstein-Barr virus, play an important role. OBJECTIVES The present study aimed to provide insight into clinical-laboratory aspects in pediatric patients with EBV after COVID-19. METHODS This prospective study was conducted from November 2021 to November 2022 at the Tbilisi state medical university G. Zhvania Pediatric Academic Clinic. 1- 3 years old, 81 outpatients with EBV infection (male 42 [51,8%] and female 66 [48,1%]) were distributed into basic (42 patients after acute SARS-CoV-2 infection) and control groups (32 patients without a history of COVDI-19). All study subjects had EBV infection markers, and conventional clinical/laboratory indices evaluated. RESULTS The incidence of EBV infection is high (60.4%) in the post-COVID-19 period. Tonsil enlargement, cough, and splenomegaly were more prevalent in the basic group than in the control group: 85,7% vs. 40,6%, 81,6%, 85,7% vs. 20,5%, and 79,5% vs. 25,6%, respectively. CONCLUSIONS The increased incidence of EBV infection in children after the COVID-19 pandemic is a challenge requiring optimized clinical care strategies.