Modification of the course of post-COVID syndrome associated with reactivation of chronic persistent Epstein−Barr virus infection and chronic nasopharyngotonsillitis of mixed etiology

Abstract

A wide range of symptoms that occur in patients with post-COVID syndrome can include both manifestations of the clinical consequences of COVID-19 and symptoms of an exacerbation of a chronic pathology that they had before the development of coronavirus infection. Correct assessment of clinical data can help determine the origin of the existing manifestations of the disease and build a plan for adequate diagnostic and therapeutic measures.

In the article, on the example of a clinical case, a variant of the modified (exacerbation of chronic pathology) course of the post-COVID syndrome was analyzed. An example of modern laboratory diagnostics of reactivation of chronic persistent Epstein–Barr virus infection and exacerbation of chronic nasopharyngotonsillitis of mixed viral-bacterial-mycotic etiology, developed against the background of post-COVID syndrome, is given. The principles of therapy for this comorbid condition are presented and explained.

Keywords

post-COVID syndrome / Epstein–Barr virus infection / chronic nasopharyngotonsillitis / coronovirus infection / SARS-CoV-2

References

[1] Belotserkovskaya YuG, Romanovskikh AG, Smirnov IP, et al. Long COVID-19. Consilium Medicum. 2021;23(3):261–268. (In Russ.). DOI: 10.26442/20751753.2021.3.200805

[2] Белоцерковская Ю.Г., Романовских А.Г., Смирнов И.П. и др. Долгий COVID-19 // Consilium Medicum. 2021. Т. 23, № 3. С. 261–268. DOI: 10.26442/20751753.2021.3.200805

[3] Khasanova DR, Zhitkova YuV, Vaskaeva GR. Postcovid syndrome: a review of knowledge about the pathogenesis, neuropsychiatric manifestations and treatment prospects. Neurology, neuropsychiatry, psychosomatics. 2021;13(3):93–98. (In Russ.). DOI: 10.14412/2074-27112021-3-93-98

[4] Хасанова Д.Р., Житкова Ю.В., Васкаева Г.Р. Постковидный синдром: обзор знаний о патогенезе, нейропсихиатрических проявлениях и перспективах лечения // Неврология, нейропсихиатрия, психосоматика. 2021. Т. 13, № 3. С. 93–98. DOI: 10.14412/2074-27112021-3-93-98

[5] Amirov NB, Davletshina EI, Vasilyeva AG, Fatykhov RG. Postcovid syndrome: multisystem “deficiencies”. Bulletin of modern clinical medicine. 2021;14(6):94–104. (In Russ.). DOI: 10.20969/VSKM.2021.14(6).94-104

[6] Амиров Н.Б., Давлетшина Э.И., Васильева А.Г., Фатыхов Р.Г. Постковидный синдром: мультисистемные «дефициты» // Вестник современной клинической медицины. 2021. Т. 14, № 6. С. 94–104. DOI: 10.20969/VSKM.2021.14(6).94-104

[7] Metodicheskie rekomendatsii “Osobennosti techeniya long-COVID infektsii. Terapevticheskie i reabilitatsionnye meropriyatiya”. 217 p. [Internet]. Available from: https://irk-gb6.ru/images/uploads/c0c122cdc473c3b9968cce024a0ccdac.pdf. Accessed: 02.09.2023. (In Russ.)

[8] Методические рекомендации «Особенности течения long-COVID инфекции. Терапевтические и реабилитационные мероприятия». 217 с. [Электронный ресурс]. Режим доступа: https://irk-gb6.ru/images/uploads/c0c122cdc473c3b9968cce024a0ccdac.pdf. Дата обращения: 09.02.2023.

[9] COVID-19 rapid guideline: managing the long-term effects of COVID-19 [Internet]. Available from: https://www.nice.org.uk/guidance/ng188. Accessed: 31.08.2021.

[10] COVID-19 rapid guideline: managing the long-term effects of COVID-19 [Электронный ресурс]. Режим доступа: https://www.nice.org.uk/guidance/ng188. Дата обращения: 31.08.2021.

[11] Diaz JV, Soriano JB. A Delphi consensus to advance on a clinical case definition for post COVID-19 condition: a WHO protocol. Protocol Exchange. 2021. DOI: 10.21203/rs.3.pex-1480/v1

[12] Diaz J.V., Soriano J.B. A Delphi consensus to advance on a clinical case definition for post COVID-19 condition: a WHO protocol // Protocol Exchange. 2021. DOI: 10.21203/rs.3.pex-1480/v1

[13] Kabi A, Mohanty A, Mohanty AP, Kumar S. Post COVID-19 syndrome: a literature review. JAMMR. 2020;32(24):289–295. DOI: 0.9734/jammr/2020/v32i2430781

[14] Kabi A., Mohanty A., Mohanty A.P., Kumar S. Post COVID-19 syndrome: a literature review // JAMMR. 2020. Vol. 32, No. 24. P. 289–295. DOI: 10.9734/jammr/2020/v32i2430781

[15] Nalbandian A, Sehgal K, Gupta A, et al. Post-acute COVID-19 syndrome. Nat Med. 2021;27(4):601–615. DOI: 10.1038/s41591-021-01283-z

[16] Nalbandian A., Sehgal K., Gupta A. et al. Post-acute COVID-19 syndrome // Nat. Med. 2021. Vol. 27, No. 4. P. 601–615. DOI: 10.1038/s41591-021-01283-z

[17] Perrin R, Riste L, Hann M, et al. Into the looking glass: Post-viral syndrome post COVID-19. Med hypotheses. 2020;144:110055. DOI: 10.1016/j.mehy.2020.110055

[18] Perrin R., Riste L., Hann M. et al. Into the looking glass: Post-viral syndrome post COVID-19 // Med. Hypotheses. 2020. Vol. 144. P. 110055. DOI: 10.1016/j.mehy.2020.110055

[19] Long COVID or Post-COVID Conditions. CDC, 2021 [Internet]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html. Accessed: 18.07.2021.

[20] Long COVID or Post-COVID Conditions. CDC 2021 [Электронный ресурс]. Режим доступа: https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html. Дата обращения: 18.07.2021.

[21] van Kampen JJA, van de Vijver DAMC, Fraaij PLA et al. Duration and key determinants of infectious virus shedding in hospitalized patients with coronavirus disease-2019 (COVID-19). Nat. Commun. 2021. Vol. 267, No. 12. P. 1–6. DOI: 10.1038/s41467-020-20568-4

[22] van Kampen J.J.A., van de Vijver D.A.M.C., Fraaij P.L.A. et al. Duration and key determinants of infectious virus shedding in hospitalized patients with coronavirus disease-2019 (COVID-19) // Nat. Commun. 2021. Vol. 267, No. 12. P. 1–6. DOI: 10.1038/s41467-020-20568-4

[23] Marx V. Scientists set out to connect the dots on long COVID. Nat Methods. 2021;18(5):449–453. DOI: 10.1038/s41592-021-01145-z13

[24] Marx V. Scientists set out to connect the dots on long COVID // Nat. Methods. 2021. Vol. 18, No. 5. P. 449–453. DOI: 10.1038/s41592-021-01145-z

[25] Avanzato VA, Matson MJ, Seifert SN, et al. Case study: Prolonged infectious SARS-CoV-2 shedding from an asymptomatic immunocompromised cancer patient. Cell. 2020;183(7):1901–1912. DOI: 10.1016/j.cell.2020.10.049

[26] Avanzato V.A., Matson M.J., Seifert S.N. et al. Case study: Prolonged infectious SARS-CoV-2 shedding from an asymptomatic immunocompromised cancer patient // Cell. 2020. Vol. 183, No. 7. P. 1901–1912. DOI: 10.1016/j.cell.2020.10.049

[27] Choi B, Choudhary MC, Regan J, et al. Persistence and evolution of SARS-CoV-2 in an immunocompromised host. N Engl J Med. 2020;383(22):2291–2293. DOI: 10.1056/NEJMc2031364

[28] Choi B., Choudhary M.C., Regan J. et al. Persistence and evolution of SARS-CoV-2 in an immunocompromised host // N. Engl. J. Med. 2020. Vol. 383, No. 22. P. 2291–2293. DOI: 10.1056/NEJMc2031364

[29] Nagasaki Y, Kadowaki M, Nakamura A, et al. A case of a malignant lymphoma patient persistently infected with SARS-CoV-2 for more than 6 months. Medicina (Kaunas). 2023;59(1):108. DOI: 10.3390/medicina59010108

[30] Nagasaki Y., Kadowaki M., Nakamura A. et al. A case of a malignant lymphoma patient persistently infected with SARS-CoV-2 for more than 6 months // Medicina (Kaunas). 2023. Vol. 59, No. 1. P. 108. DOI: 10.3390/medicina59010108

[31] Camprubí D, Gaya A, Marcos MA, et al. Persistent replication of SARS-CoV-2 in a severely immunocompromised patient treated with several courses of remdesivir. Int J Infect Dis. 2021;104:379–381. DOI: 10.1016/j.ijid.2020.12.050

[32] Camprubí D., Gaya A., Marcos M.A. et al. Persistent replication of SARS-CoV-2 in a severely immunocompromised patient treated with several courses of remdesivir // Int. J. Infect. Dis. 2021. Vol. 104. P. 379–381. DOI: 10.1016/j.ijid.2020.12.050

[33] Helleberg M, Niemann CU, Moestrup KS, et al. Persistent COVID-19 in an immunocompromised patient temporarily responsive to two courses of remdesivir therapy. J Infect Dis. 2020;222(7):1103–1107. DOI: 10.1093/infdis/jiaa446

[34] Helleberg M., Niemann C.U., Moestrup K.S. et al. Persistent COVID-19 in an immunocompromised patient temporarily responsive to two courses of remdesivir therapy // J. Infect. Dis. 2020. Vol. 222, No. 7. P. 1103–1107. DOI: 10.1093/infdis/jiaa446

[35] Moore JL, Ganapathiraju PV, Kurtz CP, Wainscoat B. A 63-year-old woman with a history of non-hodgkin lymphoma with persistent SARS-CoV-2 infection who was seronegative and treated with convalescent plasma. Am J Case Rep. 2020;21:e927812. DOI: 10.12659/AJCR.927812

[36] Moore J.L., Ganapathiraju P.V., Kurtz C.P., Wainscoat B. A 63-year-old woman with a history of non-hodgkin lymphoma with persistent SARS-CoV-2 infection who was seronegative and treated with convalescent plasma // Am. J. Case Rep. 2020. Vol. 21. P. e927812. DOI: 10.12659/AJCR.927812

[37] Tenforde MW, Kim SS, Lindsell CJ, et al. Symptom duration and risk factors for delayed return to usual health among outpatients with COVID-19 in a multistate health care systems network – United States, March–June 2020. MMWR Morb Mortal Wkly Rep. 2020;69(30):993–998. DOI: 10.15585/mmwr.mm6930e1

[38] Tenforde M.W., Kim S.S., Lindsell C.J. et al. Symptom duration and risk factors for delayed return to usual health among outpatients with COVID-19 in a multistate health care systems network – United States, March–June 2020 // MMWR. Morb. Mortal. Wkly. Rep. 2020. Vol. 69, No. 30. P. 993–998. DOI: 10.15585/mmwr.mm6930e1

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