International Journal of Infectious Diseases (Mar 2021)

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

  • Stefania Paolucci,
  • Irene Cassaniti,
  • Federica Novazzi,
  • Loretta Fiorina,
  • Antonio Piralla,
  • Giuditta Comolli,
  • Raffaele Bruno,
  • Renato Maserati,
  • Roberto Gulminetti,
  • Stefano Novati,
  • Francesco Mojoli,
  • Fausto Baldanti,
  • R Bruno,
  • M Mondelli,
  • E Brunetti,
  • A Di Matteo,
  • E Seminari,
  • L Maiocchi,
  • V Zuccaro,
  • L Pagnucco,
  • B Mariani,
  • S Ludovisi,
  • R Lissandrin,
  • A Parisi,
  • P Sacchi,
  • SFA Patruno,
  • G Michelone,
  • R Gulminetti,
  • D Zanaboni,
  • S Novati,
  • R Maserati,
  • P Orsolini,
  • M Vecchia,
  • M Sciarra,
  • E Asperges,
  • M Colaneri,
  • A Di Filippo,
  • M Sambo,
  • S Biscarini,
  • M Lupi,
  • S Roda,
  • TC Pieri,
  • I Gallazzi,
  • M Sachs,
  • P Valsecchi,
  • S Perlini,
  • C Alfano,
  • M Bonzano,
  • F Briganti,
  • G Crescenzi,
  • AG Falchi,
  • R Guarnone,
  • B Guglielmana,
  • E Maggi,
  • I Martino,
  • P Pettenazza,
  • S Pioli di Marco,
  • F Quaglia,
  • A Sabena,
  • F Salinaro,
  • F Speciale,
  • I Zunino,
  • M De Lorenzo,
  • G Secco,
  • L Dimitry,
  • G Cappa,
  • I Maisak,
  • B Chiodi,
  • M Sciarrini,
  • B Barcella,
  • F Resta,
  • L Moroni,
  • G Vezzoni,
  • L Scattaglia,
  • E Boscolo,
  • C Zattera,
  • MF Tassi,
  • V Capozza,
  • D Vignaroli,
  • M Bazzini,
  • G Iotti,
  • F Mojoli,
  • M Belliato,
  • L Perotti,
  • S Mongodi,
  • G Tavazzi,
  • G Marseglia,
  • A Licari,
  • I Brambilla,
  • D Barbarini,
  • A Bruno,
  • P Cambieri,
  • G Campanini,
  • C. Cavanna,
  • G Comolli,
  • M Corbella,
  • R Daturi,
  • M Furione,
  • B Mariani,
  • P Marone,
  • R Maserati,
  • E Monzillo,
  • S Paolucci,
  • M Parea,
  • E Percivalle,
  • A Piralla,
  • F Rovida,
  • A Sarasini,
  • M Zavattoni,
  • G Adzasehoun,
  • M Ardizzone,
  • L Bellotti,
  • V Brunco,
  • E Cabano,
  • G Casali,
  • L Capella,
  • D Devitis,
  • L Dossena,
  • G Frisco,
  • G Garbagnoli,
  • F Gardellini,
  • A Girello,
  • A Guerrizio,
  • V Landini,
  • C Lucchelli,
  • V Maliardi,
  • P Piemontese,
  • S Pezzaia,
  • M Premoli,
  • C Rebuffa,
  • C Zanello,
  • J Bagnarino,
  • F Bergami,
  • A Bonetti,
  • G Caneva,
  • I Cassaniti,
  • A Corcione,
  • R Di Martino,
  • A Di Napoli,
  • A Ferrari,
  • G Ferrari,
  • L Fiorina,
  • A Gallone,
  • F Giardina,
  • A Girardi,
  • A Mercato,
  • C Merla,
  • F Novazzi,
  • G Ratano,
  • B Rossi,
  • G Saveriaempillai,
  • IM Sciabica,
  • M Tallarita,
  • E Vecchio Nepita,
  • J Vitali,
  • A Cerino,
  • S Varchetta,
  • B Oliviero,
  • S Mantovani,
  • D Mele,
  • M Calvi,
  • M Tizzoni,
  • C Nicora,
  • A Triarico,
  • V Petronella,
  • C Marena,
  • A Muzzi,
  • P Lago,
  • S Cutti,
  • V Novelli,
  • F Comandatore,
  • G BatistiBiffignandi,
  • S Gaiarsa,
  • M Rettani,
  • C Bandi,
  • A Ferrari

Journal volume & issue
Vol. 104
pp. 315 – 319

Abstract

Read online

Objectives: The immunologic profile and opportunistic viral DNA increase were monitored in Italian patients with COVID-19 in order to identify markers of disease severity. Methods: 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. Results: 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). Conclusions: 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.

Keywords