ANALYSIS OF CLINICAL AND EPIDEMIOLOGICAL FEATURES OF HERPESVIRUS REACTIVATION IN INDIVIDUALS WITH A HISTORY OF COVID-19

Abstract

Introduction. Herpesvirus reactivation in patients with a history of Coronavirus disease (COVID-19) is an increasingly recognized problem that may exacerbate the clinical manifestations of post-COVID syndrome. Reactivation of latent viruses such as herpes simplex virus (HSV), Epstein–Barr virus (EBV), and cytomegalovirus (CMV) has been frequently observed, but the clinical and epidemiological features of this phenomenon remain insufficiently studied. Objective. To investigate the clinical and epidemiological characteristics of herpesvirus reactivation (CMV, EBV, HSV) in patients after COVID-19, based on a comprehensive analysis of symptoms and laboratory findings. Methods. A retrospective analytical case–control study was conducted, including 80 patients, of whom 40 comprised the main group with a confirmed history of COVID-19, and 40 formed the control group without any indication of previous COVID-19. The analysis included the assessment of clinical symptoms, results of specific immunological testing by enzymelinked immunosorbent assay (ELISA) for IgG and IgM antibodies to herpesviruses, as well as laboratory parameters, including complete blood count and biochemical profile. Statistical analysis was performed using nonparametric tests, including the Mann–Whitney U test and Pearson’s chi-square test. Statistical significance was set at p < 0.05. Results. Cytomegalovirus was the most frequently reactivated herpesvirus (30%). Reactivation occurred significantly more often in patients with moderate to severe COVID-19 compared to those with mild disease (75% vs. 33.3%; p = 0.036). Patients with reactivation more frequently presented with peripheral lymphadenopathy (85% vs. 47.5%; p = 0.0009) and febrile fever (25% vs. 5%; p = 0.028). Serological testing revealed elevated IgG titers with high optical density and absence of IgM, indicating reactivation. CRP (p = 0.002) and blood glucose (p = 0.035) levels were also significantly higher in the reactivation group. Conclusion. The study identified a range of clinical and laboratory features associated with herpesvirus reactivation in patients following COVID-19. These findings highlight the relevance of comprehensive post-COVID assessment, considering potential interactions between SARS-CoV-2 and latent viruses, and support the inclusion of herpesvirus screening in postCOVID monitoring protocols.