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Maguire Cole, Chen Jing, Rouphael Nadine, Morse Brinkley A, Hoch Annmarie, Pickering Harry, Phan Hoang Van, Glascock Abigail, Chu Victoria, Dandekar Ravi, IMPACC Network, Corry David, Kheradmand Farrah, Baden Lindsey R, Sekaly Rafick-Pierre, McComsey Grace A, Haddad Elias K, Cairns Charles B, Pulendran Bali, Fernandez-Sesma Ana, Simon Viviana, Metcalf Jordan P, Agudelo Higuita Nelson I, Messer William B, Davis Mark M, Nadeau Kari C, Kraft Monica, Bime Chris, Schaenman Joanna, Erle David, Calfee Carolyn S, Atkinson Mark A, Brakenridge Scott C, Ehrlich Lauren I R, Montgomery Ruth R, Shaw Albert, Hough Catherine L, Hafler David, Augustine Alison D, Becker Patrice M, Peters Bjoern, Ozonoff Al, Kim-Schulze Seunghee, Krammer Florian, Bosinger Steven E, Eckalbar Walter, Altman Matthew C, Wilson Michael, Guan Leying, Kleinstein Steven H, Smolen Kinga K, Reed Elaine F, Levy Ofer, Maecker Holden, Hunt Peter, Steen Hanno, Diray-Arce Joann, Langelier Charles R, Melamed Esther
Аннотация
Chronic viral infections are ubiquitous in humans, with individuals carrying multiple viruses that can reactivate during physiological stress, including severe illness1. Notably, SARS-CoV-2 infection has been shown to reactivate chronic viruses such as Epstein-Barr virus and cytomegalovirus, yet the full extent, temporal dynamics and immunological impact of viral reactivation in COVID-19 remain incompletely understood2-7. Here, leveraging multi-omic longitudinal data from 1,154 hospitalized patients with COVID-19 from the Immunophenotyping Assessment in a COVID-19 Cohort (IMPACC) study, we reveal significant reactivation of Herpesviridae and Anelloviridae during acute COVID-19, with distinct temporal dynamics for different viruses, and demonstrate that reactivation correlates with disease severity, host immune effects and clinical outcomes. Although our results do not establish causation between virus reactivation and clinical outcomes, we highlight the prevalence of chronic viral reactivation during acute COVID-19 and long COVID. Our findings challenge the prevailing view that chronic viral reactivation is primarily a consequence of immunosuppression, demonstrating that reactivations occur frequently in immunocompetent individuals during severe illness and in association with increased systemic inflammation. Additionally, we demonstrate persistence of viral reactivation in convalescence, and report an association of Anelloviridae with long COVID. This study provides immune, transcriptomic and metabolomic signatures of viral reactivation that could inform future strategies to prognosticate and treat acute COVID-19 and long COVID.