Systematic review with meta-analysis of active herpesvirus infections in patients with COVID-19: Old players on the new field, 2023, Ana Banko et al

ABSTRACT
Objectives
Herpesviruses are ubiquitous and after primary infection they establish lifelong latency. The impairment of maintaining latency with short-term or long-term consequences could be triggered by other infection. Therefore, reactivation of herpesviruses in COVID-19 patients represents an emerging issue.

Design and methods
This study provided the first systematic review with meta-analysis of studies that evaluated active human herpesvirus (HHV) infection (defined as the presence of IgM antibodies or HHV-DNA) in COVID-19 patients and included 36 publications collected by searching through PubMed, SCOPUS, and Web of science until November 2022.

Results
The prevalence of active EBV, HHV6, HSV, CMV, HSV1, and VZV infection in COVID-19 population was 41% (95% CI =27%-57%), 3% (95% CI=17%-54%), 28% (95% CI=1%-85%), 25% (95% CI=1%-63%), 22% (95% CI=10%-35%), and 18% (95% CI=4%-34%), respectively. There was a 6 times higher chance for active EBV infection in patients with severe COVID-19 than in non-COVID-19 controls (OR=6.45, 95% CI=1.09-38.13, p=0.040), although there was no difference in the prevalence of all evaluated active herpesvirus infections between COVID-19 patients and non-COVID-19 controls.

Conclusions
Future research of herpesvirus and SARS-CoV-2 coinfections must be prioritized to define: who, when and how to be tested, as well as how to effectively treat HHVs reactivations in acute and long COVID-19 patients.

https://www.sciencedirect.com/science/article/pii/S1201971223000371

 

It's so disappointing that medicine hasn't progressed beyond the simple thinking of one pathogen = one outcome and always the same for everyone.

Peptic ulcers have a similar context, nearly everyone carries H. Pylori, but not everyone develops ulcers. There are other factors at play, and they are very poorly understood. It's so weird in fact that people who don't carry H. Pylori have health issues of their own, this is what Barry Marshall has been researching.

The same flawed thinking can be seen all over the place, this reductive thinking of one factor = one universal outcome. I've seen it applied to COVID infections, to Long Covid caused by infection or vaccination. There is always that thinking where something is only real if it always follows the exact same path. And then you have stuff like "typical symptoms of", which is just absurdly invalid given how much overlap there is between all types of illness.

Even though it's widely understood that this isn't the case. There is a blatant lack of nuance because it's impossible to be sure, but there is a greater need to be sure than there is to be right.