EBV DNA increase in COVID-19 patients with impaired lymphocyte subpopulation count

• Published in: International journal of infectious diseases Vol. 104; pp. 315 - 319
• Main Authors: Paolucci, Stefania, Cassaniti, Irene, Novazzi, Federica, Fiorina, Loretta, Comolli, Giuditta, Bruno, Raffaele, Gulminetti, Roberto, Novati, Stefano, Bruno, R, Brunetti, E, Di Matteo, A, Seminari, E, Maiocchi, L, Pagnucco, L, Mariani, B, Ludovisi, S, Gulminetti, R, Novati, S, Vecchia, M, Sciarra, M, Colaneri, M, Di Filippo, A, Sambo, M, Biscarini, S, Roda, S, Pieri, TC, Gallazzi, I, Sachs, M, Valsecchi, P, Perlini, S, Bonzano, M, Crescenzi, G, Falchi, AG, Guarnone, R, Quaglia, F, Sabena, A, Speciale, F, Zunino, I, Secco, G, Maisak, I, Chiodi, B, Sciarrini, M, Barcella, B, Moroni, L, Vignaroli, D, Bazzini, M, Belliato, M, Perotti, L, Mongodi, S, Tavazzi, G, Marseglia, G, Licari, A, Comolli, G, Corbella, M, Daturi, R, Furione, M, Marone, P, Percivalle, E, Piralla, A, Zavattoni, M, Adzasehoun, G, Ardizzone, M, Bellotti, L, Brunco, V, Cabano, E, Capella, L, Frisco, G, Garbagnoli, G, Gardellini, F, Girello, A, Guerrizio, A, Lucchelli, C, Maliardi, V, Zanello, C, Bagnarino, J, Bergami, F, Caneva, G, Corcione, A, Di Martino, R, Gallone, A, Merla, C, Novazzi, F, Rossi, B, Saveriaempillai, G, Tallarita, M, Vecchio Nepita, E, Vitali, J, Cerino, A, Oliviero, B, Mantovani, S, Mele, D, Calvi, M, Tizzoni, M, Nicora, C, Triarico, A, Muzzi, A, Lago, P, Novelli, V, Comandatore, F, Bandi, C
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Ltd 01-03-2021; The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases; Elsevier
• Subjects: Aged; Aged, 80 and over; CD8-Positive T-Lymphocytes - virology; COVID-19; COVID-19 - complications; COVID-19 - virology; DNA, Viral - analysis; EBV DNA; Epstein-Barr Virus Infections - complications; Epstein-Barr Virus Infections - diagnosis; Epstein-Barr Virus Infections - virology; Female; Herpesvirus 4, Human - genetics; Herpesvirus 4, Human - isolation & purification; Humans; Intensive Care Units; Killer Cells, Natural - virology; Lymphocyte Count; Lymphocyte subpopulation; Lymphocyte Subsets - virology; Male; Middle Aged; Opportunistic Infections; Real-Time Polymerase Chain Reaction; SARS-CoV-2; Viral Load; COVID-19; EBV DNA; Lymphocyte subpopulation
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2020.12.051

•EBV reactivation was observed in patients with COVID-19.•NK+and CD8+T cell reduction was related to the severity of COVID-19 infection.•An increase of B cells in patients with severe symptoms was documented.
The immunologic profile and opportunistic viral DNA increase were monitored in Italian patients with COVID-19 in order to identify markers of disease severity.
A total of 104 patients infected with SARS-CoV-2 were evaluated in the study. Of them, 42/104 (40.4%) were hospitalized in an intensive care unit (ICU) and 62/104(59.6%) in a sub-intensive care unit (SICU). Human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV), Parvovirus B19 and Human Herpesvirus 6 virus reactivations were determined by real-time PCR, and lymphocyte subpopulation counts were determined by flow cytometry.
Among opportunistic viruses, only EBV was consistently detected. EBV DNA was observed in 40/42 (95.2%) of the ICU patients and in 51/61 (83.6%) of the SICU patients. Comparing the two groups of patients, the EBV DNA median level among ICU patients was significantly higher than that observed in SICU patients. In parallel, a significant reduction of CD8 T cell and NK count in ICU patients as compared with SICU patients was observed (p<0.05). In contrast, B cell count was significantly increased in ICU patients (p=0.0172).
A correlation between reduced CD8+ T cells and NK counts, EBV DNA levels and COVID-19 severity was observed. Other opportunistic viral infections were not observed. The relationship between EBV load and COVID-19 severity should be further evaluated in longitudinal studies.