Skip to main content
Top
Published in: BMC Infectious Diseases 1/2021

Open Access 01-12-2021 | Epstein-Barr Virus | Research article

Clinical characteristics and outcomes of critically ill patients with acute COVID-19 with Epstein-Barr virus reactivation

Authors: Yun Xie, Song Cao, Hui Dong, Hui Lv, Xiaolei Teng, Jiaxiang Zhang, Tao Wang, Xiaoyan Zhang, Yun Qin, Yujing Chai, Luyu Yang, Jun Liu, Ruilan Wang

Published in: BMC Infectious Diseases | Issue 1/2021

Login to get access

Abstract

Background

Our goal is to further elucidate the clinical condition and prognosis of patients with severe acute COVID-19 with EBV reactivation.

Method

This is a retrospective single-center study of COVID-19 patients admitted to the intensive care unit of Wuhan No. 3 Hospital (January 31 to March 27, 2020). According to whether Epstein-Barr virus reactivation was detected, the patients were divided into an EBV group and a Non-EBV group. Baseline data were collected including epidemiological, larithmics, clinical and imaging characteristics, and laboratory examination data.

Results

Of the 128 patients with COVID-19, 17 (13.3%) were infected with Epstein-Barr virus reactivation. In the symptoms,the rate of tachypnoea in the EBV group was apparently higher than that in the Non-EBV group. In lab tests, the lymphocyte and albumin of EBV group decreased more significantly than Non-EBV group, and the D-dimer and serum calcium of EBV group was higher than Non-EBV group. Regarding the infection index, CRP of EBV group was apparently above the Non-EBV group, and no significant difference was found in procalcitonin of the two groups. The incidence of respiratory failure, ARDS, and hypoproteinaemia of EBV group had more incidence than Non-EBV group. The 28-day and 14-day mortality rates of EBV group was significantly higher than that of Non-EBV group.

Conclusions

In the COVID-19 patients, patients with EBV reactivation had higher 28-day and 14-day mortality rates and received more immuno-supportive treatment than patients of Non-EBV group.
Literature
1.
go back to reference Yu P, Zhu J, Zhang Z, et al. A familial cluster of infection associated with the 2019 novel coronavirus indicating potential person-to-person transmission during the incubation period. J Infect Dis. 2020;221:1757.CrossRef Yu P, Zhu J, Zhang Z, et al. A familial cluster of infection associated with the 2019 novel coronavirus indicating potential person-to-person transmission during the incubation period. J Infect Dis. 2020;221:1757.CrossRef
2.
go back to reference Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507.CrossRef Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507.CrossRef
4.
go back to reference Dellis O, Arbabian A, Papp B, et al. Epstein-Barr virus latent membrane protein 1 increases calcium influx through store-operated channels in B lymphoid cells. J Biol Chem. 2011;286(21):18583–92.CrossRef Dellis O, Arbabian A, Papp B, et al. Epstein-Barr virus latent membrane protein 1 increases calcium influx through store-operated channels in B lymphoid cells. J Biol Chem. 2011;286(21):18583–92.CrossRef
6.
go back to reference Okano M, Kawa K, Kimura H, et al. Proposed guidelines for diagnosing chronic active Epstein-Barr virus infection. Am J Hematol. 2005;80(1):64–9.CrossRef Okano M, Kawa K, Kimura H, et al. Proposed guidelines for diagnosing chronic active Epstein-Barr virus infection. Am J Hematol. 2005;80(1):64–9.CrossRef
7.
go back to reference Xie Y, Cao S, Dong H, et al. Effect of regular intravenous immunoglobulin therapy on prognosis of severe pneumonia in patients with COVID-19. J Infect. 2020;81(2):318–56.CrossRef Xie Y, Cao S, Dong H, et al. Effect of regular intravenous immunoglobulin therapy on prognosis of severe pneumonia in patients with COVID-19. J Infect. 2020;81(2):318–56.CrossRef
8.
go back to reference Xie Y, Dong H, Liao Y, et al. A prediction model of mortality in COVID-19 pneumonia based on CT score and lymphocyte count. Austin J Pathol Lab Med. 2021;8(1):1030. Xie Y, Dong H, Liao Y, et al. A prediction model of mortality in COVID-19 pneumonia based on CT score and lymphocyte count. Austin J Pathol Lab Med. 2021;8(1):1030.
9.
go back to reference Deng YY, Lu PX, Yang GL, et al. Correlative study of semi-quantitative score of chest CT findings and viral load in novel influenza A (H1N1)virus infection. Radiol Practi ce. 2010;25(9):965–8. Deng YY, Lu PX, Yang GL, et al. Correlative study of semi-quantitative score of chest CT findings and viral load in novel influenza A (H1N1)virus infection. Radiol Practi ce. 2010;25(9):965–8.
10.
go back to reference Taisheng L, Zhifeng Q, Linqi Z, et al. Significant changes of peripheral T lymphocyte subsets in patients with severe acute respiratory syndrome. J Infect Dis. 2004;189(4):648–51.CrossRef Taisheng L, Zhifeng Q, Linqi Z, et al. Significant changes of peripheral T lymphocyte subsets in patients with severe acute respiratory syndrome. J Infect Dis. 2004;189(4):648–51.CrossRef
11.
go back to reference Liu ZY, Li TS, Wang Z, et al. Clinical features and therapy of 106 cases of severe acute respiratory syndrome. Chin J Intern Med. 2003;06:16–20. Liu ZY, Li TS, Wang Z, et al. Clinical features and therapy of 106 cases of severe acute respiratory syndrome. Chin J Intern Med. 2003;06:16–20.
12.
go back to reference Li TS, Qiu ZF, Han Y, et al. The alterations of T cell subsets of severe acute respiratory syndrome during acute phase. Chin J Lab Med. 2003;05:40–2. Li TS, Qiu ZF, Han Y, et al. The alterations of T cell subsets of severe acute respiratory syndrome during acute phase. Chin J Lab Med. 2003;05:40–2.
13.
go back to reference Lin L, Lu L, Cao W, et al. Hypothesis for potential pathogenesis of SARS-CoV-2 infection–a review of immune changes in patients with viral pneumonia. Emerg Microbes Infect. 2020;9:1–14.CrossRef Lin L, Lu L, Cao W, et al. Hypothesis for potential pathogenesis of SARS-CoV-2 infection–a review of immune changes in patients with viral pneumonia. Emerg Microbes Infect. 2020;9:1–14.CrossRef
14.
go back to reference Amir R, Kichloo A, Singh J, et al. Epstein-Barr virus versus novel coronavirus-induced hemophagocytic lymphohistocytosis: the uncharted waters. J Investig Med High Impact Case Rep. 2020;8:2324709620950107.PubMedPubMedCentral Amir R, Kichloo A, Singh J, et al. Epstein-Barr virus versus novel coronavirus-induced hemophagocytic lymphohistocytosis: the uncharted waters. J Investig Med High Impact Case Rep. 2020;8:2324709620950107.PubMedPubMedCentral
15.
go back to reference Pedersen M, Asprusten TT, Godang K, et al. Predictors of chronic fatigue in adolescents six months after acute Epstein-Barr virus infection: a prospective cohort study. Brain Behav Immun. 2019;75:94–100.CrossRef Pedersen M, Asprusten TT, Godang K, et al. Predictors of chronic fatigue in adolescents six months after acute Epstein-Barr virus infection: a prospective cohort study. Brain Behav Immun. 2019;75:94–100.CrossRef
16.
go back to reference Shasha H, Yan W, Haiyang C, et al. C-Reactive Protein/Albumin Ratio (CAR) as a prognostic factor in patients with non-metastatic nasopharyngeal carcinoma. J Cancer. 2016;7(15):2360–6.CrossRef Shasha H, Yan W, Haiyang C, et al. C-Reactive Protein/Albumin Ratio (CAR) as a prognostic factor in patients with non-metastatic nasopharyngeal carcinoma. J Cancer. 2016;7(15):2360–6.CrossRef
Metadata
Title
Clinical characteristics and outcomes of critically ill patients with acute COVID-19 with Epstein-Barr virus reactivation
Authors
Yun Xie
Song Cao
Hui Dong
Hui Lv
Xiaolei Teng
Jiaxiang Zhang
Tao Wang
Xiaoyan Zhang
Yun Qin
Yujing Chai
Luyu Yang
Jun Liu
Ruilan Wang
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2021
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-021-06638-y

Other articles of this Issue 1/2021

BMC Infectious Diseases 1/2021 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.