Clinical relevance of circulating blood microaggregates and reactivation of Epstein Barr Virus in long-term Post-CoVID syndrome patients

Abstract:

Chronic persistence of systemic symptoms after recovery from active CoVID-19 has become a significant disease burden, named post-CoVID syndrome. Among many pathophysiological hypotheses we focus on impaired hemostasis as well as reactivation of latent Epstein-Barr virus.

We now introduce a novel diagnostic morphological approach for visualizing microaggregates circulating in peripheral venous blood, which are large enough to impede capillary blood flow. In addition, secretion of interferon gamma by mononuclear leukocytes in response to peptides of Epstein-Barr virus is increased in these patients.

As a promising therapeutic approach, we provide retrospective data on the effect of anti-thrombotic and virostatic drugs, respectively. In a large number of patients, clinical improvement was observed after platelet inhibition, particularly when EBV was also treated with antiviral therapy.

Source: Wick N, Hermann M, Lisch C, Gerth R, Wick G, Untersmayr E, Marth T, Bachler M, Fries D. Clinical relevance of circulating blood microaggregates and reactivation of Epstein Barr Virus in long-term Post-CoVID syndrome patients. Sci Rep. 2026 Mar 8. doi: 10.1038/s41598-026-42952-8. Epub ahead of print. PMID: 41796205. https://www.nature.com/articles/s41598-026-42952-8 (Full text available as PDF file)

Decreased immunoreactive beta-endorphin in mononuclear leucocytes from patients with chronic fatigue syndrome

Abstract:

OBJECTIVE: To investigate beta-endorphin concentrations in the peripheral blood mononuclear cells (PBMC) of patients with chronic fatigue syndrome (CFS).

METHODS: Sixteen patients with CFS were enrolled in this study. Ten healthy subjects were studied as controls. Beta-endorphin concentrations were measured in PBMC by radioimmunoassay performed with antibodies specific for the C-terminal portion of human beta-endorphin.

RESULTS: Beta-endorphin concentrations in the PBMC of chronic fatigue patients were significantly lower (p < 0.001) than in healthy subjects (mean +/- SD: 8.5 +/- 7.0 vs. 42.6 +/- 22.6).

CONCLUSION: Patients with CFS were found to have low levels of PBMC beta-endorphin. This finding may reflect the condition of chronic immune activation in CFS that has been reported in previous investigations. Beta-endorphin concentrations in PBMC seem to mirror the central nervous system homeostasis of the opioid. Therefore, we would postulate that the fatigue and weakness typical of CFS could be related to low beta-endorphin concentrations at the central nervous system level.

 

Source: Conti F, Pittoni V, Sacerdote P, Priori R, Meroni PL, Valesini G. Decreased immunoreactive beta-endorphin in mononuclear leucocytes from patients with chronic fatigue syndrome. Clin Exp Rheumatol. 1998 Nov-Dec;16(6):729-32. http://www.ncbi.nlm.nih.gov/pubmed/9844768