{"id":3104,"date":"2023-04-04T15:30:14","date_gmt":"2023-04-04T20:30:14","guid":{"rendered":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/?p=3104"},"modified":"2023-04-04T15:30:18","modified_gmt":"2023-04-04T20:30:18","slug":"covid-isnt-just-infecting-you-it-could-be-reactivating-viruses-that-have-been-dormant-in-your-body-for-years-2","status":"publish","type":"post","link":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/2023\/04\/04\/covid-isnt-just-infecting-you-it-could-be-reactivating-viruses-that-have-been-dormant-in-your-body-for-years-2\/","title":{"rendered":"COVID isn\u2019t just infecting you\u2014it could be reactivating viruses that have been dormant in your body for years"},"content":{"rendered":"
\n

Fortune<\/a> COVID can cause reservoirs of some viruses you\u2019ve previously battled to reactivate, potentially leading to symptoms of chronic fatigue syndrome\u2014a condition that resembles long COVID, a recent study found.<\/em><\/p>\n\n\n\n

You had COVID a few months ago and recovered\u2014but things still aren\u2019t quite right. <\/p>\n\n\n\n

When you stand up, you feel dizzy, and your heart races. Even routine tasks leave you feeling spent. And what was once a good night\u2019s sleep no longer feels refreshing.<\/p>\n\n\n\n

Long COVID, right? It may not be so simple.<\/p>\n\n\n\n

A mild or even an asymptomatic case of COVID can cause reservoirs of some viruses you\u2019ve previously battled to reactivate, potentially leading to symptoms of chronic fatigue syndrome\u2014a condition that resembles long COVID, according to a recent study<\/a> published in the journal Frontiers in Immunology. <\/em><\/p>\n\n\n\n

Researchers found herpes viruses like Epstein-Barr, one of the drivers behind mono, circulating in unvaccinated patients who had experienced COVID. In patients with chronic fatigue syndrome, antibody responses were stronger, signaling an immune system struggling to fight off the lingering viruses.<\/p>\n\n\n\n

Such non-COVID pathogens have been named as likely culprits behind chronic fatigue syndrome, also known as myalgic encephalomyelitis. The nebulous condition with no definitive cause leads to symptoms like fatigue, brain fog, dizziness when moving, and unrefreshing sleep.<\/p>\n\n\n\n

The symptoms of many long COVID patients could be described as chronic fatigue syndrome, experts say. Researchers in the October study hypothesized that COVID sometimes leads to suppression of the immune system, allowing latent viruses reactivated by the stress of COVID to recirculate\u2014viruses linked to symptoms that are common in Chronic Fatigue Syndrome and long COVID. <\/p>\n\n\n\n

Thus, \u201clong COVID\u201d in some may not be an entirely new entity, but another postviral illness\u2014like ones seen in some patients after Ebola, the original SARS of 2003\u20132004, and other infections\u2014that overlaps with chronic fatigue syndrome.<\/p>\n\n\n\n

As top U.S. infectious disease expert Dr. Anthony Fauci said in 2020<\/a>, long COVID \u201cvery well might be a postviral syndrome associated with COVID-19.\u201d <\/p>\n\n\n\n

\u2018We\u2019re still not doing that\u2019<\/strong><\/h2>\n\n\n\n

It\u2019s possible that COVID is reactivating latent viruses in at least a portion of long COVID patients, causing chronic fatigue syndrome symptoms, Dr. Alba Miranda Azola, codirector of the long COVID clinic at Johns Hopkins University School of Medicine, told Fortune.<\/em><\/p>\n\n\n\n

But her clinic doesn\u2019t check for the reactivation of viruses in long COVID patients. She doesn\u2019t think the possibility of such viruses causing symptoms in patients is worth giving those patients antivirals or antibiotics, which can lead to undesirable side effects. <\/p>\n\n\n\n

\u201cWe don\u2019t have enough evidence to support that treatment,\u201d she said. <\/p>\n\n\n\n

Other physicians who have prescribed such treatments for long COVID patients, and those patients didn\u2019t see much improvement, Azola added. She recently asked an infectious disease colleague if it was standard practice to test for, and treat, latent viruses in long COVID patients.<\/p>\n\n\n\n

\u201cWe\u2019re still not doing that,\u201d she recalled him saying. <\/p>\n\n\n\n

Dr. Nir Goldstein, a pulmonologist at National Jewish Health in Denver, who runs the hospital\u2019s long COVID clinic, said it\u2019s not yet clear what role latent viruses play in the long COVID. That\u2019s because the nascent condition is such a complex and varied disorder.<\/p>\n\n\n\n

A consensus definition for long COVID hasn\u2019t been universally agreed upon. Hundreds of possible symptoms have been identified, he points out\u2014and no single explanation can account for them all.<\/p>\n\n\n\n

\u201cThere may be an association, but it\u2019s very hard to know the causation,\u201d Goldstein said. \u201cIt could be the other way around\u2014it could be that long COVID causes reactivation, not that reactivation causes long COVID.\u201d<\/p>\n\n\n\n

Dr. Panagis Galiasatos, an assistant professor at Johns Hopkins\u2019 pulmonary and critical care division who treats long COVID patients, doesn\u2019t routinely test his patients for latent viruses, given that most respond well to treatments that his clinic uses.<\/p>\n\n\n\n

\u201cIf a patient doesn\u2019t respond to treatment, maybe we\u2019ll test for other things,\u201d he said.<\/p>\n\n\n\n

There is a strong possibility that COVID is weakening the immune systems of \u201ca good deal of people,\u201d Galiasatos added.<\/p>\n\n\n\n

\u201cI do think the immunodeficiency\u2014when it\u2019s there, it\u2019s transient\u2014allows those viruses to reemerge,\u201d he said. <\/p>\n\n\n\n

Scientists are still unsure if viruses like Epstein-Barr merely initiate chronic fatigue syndrome or keep symptoms going, the October study points out. Similarly, researchers are still unsure what, if any, role latent viruses\u2014including, potentially, SARS-CoV-2 itself\u2014play in the development of long COVID.<\/p>\n\n\n\n

Few options, for now<\/strong><\/h2>\n\n\n\n

With so little known about both long COVID and chronic fatigue syndrome, it doesn\u2019t really matter which a patient has, experts say\u2014at least not right now. While the symptoms of both can be treated, there\u2019s no specific drug for either because the cause\u2014or causes\u2014remain up in the air.<\/p>\n\n\n\n

\u201cIt\u2019s the main reason why I don\u2019t even order the test,\u201d Azola said of antibody tests for possible latent viruses in long COVID patients. \u201cThere\u2019s no treatment targeting chronic fatigue syndrome. There certainly are treatments that can help with symptom management and improve quality of life, but they\u2019re not curative.\u201d<\/p>\n\n\n\n

Delineating the two conditions could matter in the future, Goldstein said, if researchers can prove that the conditions are caused by residual viruses and develop a way to eradicate them.<\/p>\n\n\n\n

Azola has several patients who were diagnosed with chronic fatigue syndrome before COVID, after Epstein-Barr virus or H1N1 flu infections. They caught COVID, and now their chronic fatigue symptoms are much worse, she says.<\/p>\n\n\n\n

\u201cThey remember the things that worked for them before, learning how to pace themselves, staying out of what I call the corona-coaster\u2014when they\u2019re feeling good, doing a lot, then crashing for days,\u201d she said. \u201cThey\u2019re able to identify with that and implement strategies that have worked for them in the past.\u201d<\/p>\n\n\n\n

Galiasatos, from Johns Hopkins, hopes that the new year brings long COVID breakthroughs, including a deeper understanding of the condition and tailored treatments\u2014potentially by the end of 2023. <\/p>\n\n\n\n

Stanford University is recruiting for a study<\/a> based on a theory similar to the one in the October study\u2014that long COVID is caused by a lingering reservoir of the SARS-CoV-2 virus, which causes COVID, after acute infection. It will attempt to determine if the antiviral drug Paxlovid alleviates long COVID symptoms by reducing or eliminating that viral reservoir.<\/p>\n\n\n\n

\u201cWe\u2019re starting to move into the trial-treatment phase slowly,\u201d Azola said.<\/p>\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"

Fortune COVID can cause reservoirs of some viruses you\u2019ve previously battled to reactivate, potentially leading to symptoms of chronic fatigue syndrome\u2014a condition that resembles long COVID, a recent study found. You had COVID a few months ago and recovered\u2014but things still aren\u2019t quite right. When you stand up, you feel dizzy, and your heart races. […]<\/p>\n","protected":false},"author":11,"featured_media":3105,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[11,7],"tags":[],"class_list":["post-3104","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-covid","category-emerging-infectious-diseases"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-content\/uploads\/2023\/04\/Screenshot-2023-04-04-at-16.26.49.png","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts\/3104","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/comments?post=3104"}],"version-history":[{"count":1,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts\/3104\/revisions"}],"predecessor-version":[{"id":3106,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts\/3104\/revisions\/3106"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/media\/3105"}],"wp:attachment":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/media?parent=3104"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/categories?post=3104"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/tags?post=3104"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}