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. 2021 Sep 15;21(1):955.
doi: 10.1186/s12879-021-06638-y.

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

Yun Xie #  1 , Song Cao #  2 , Hui Dong #  2 , Hui Lv  1 , Xiaolei Teng  1 , Jiaxiang Zhang  1 , Tao Wang  1 , Xiaoyan Zhang  1 , Yun Qin  3 , Yujing Chai  4 , Luyu Yang  2 , Jun Liu  5 , Ruilan Wang  6
Affiliations

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

Yun Xie et al. BMC Infect Dis. .

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.

Keywords: Epstein-Barr virus; Outcome; SARS-CoV-2.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Fig. 1
Fig. 1
Research flow chart
Fig. 2
Fig. 2
A. Lymphocyte counts of the two groups (B). D-dimer levels of the two groups (C). Hospital costs of the two groups (D). Hospital lengths of stay of the two groups
Fig. 3
Fig. 3
A 28-Day survival proportions B 14-Day survival proportions
Fig. 4
Fig. 4
28-Day survival proportions of Cox model
See this image and copyright information in PMC

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