12 Epstein-Barr Virus (EBV) and Long COVID
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Learning Objectives
- Explain proposed mechanisms by which Epstein–Barr virus (EBV) may contribute to immune dysregulation in Long COVID (PASC), including transcriptional reprogramming of autoreactive B cells and enhanced antigen-presenting cell (APC) activity.
- Evaluate the evidence supporting EBV reactivation as a potential contributor to post-acute infection syndromes (e.g., PASC, PTLD, ME/CFS).
- Discuss the translational implications of EBV-driven B cell pathology in PASC, including how targeted B cell depletion strategies could test mechanistic hypotheses and inform therapeutic development.
Video Module: EBV and Long COVID
Faculty:
- William H. Robinson, MD, PhD – Professor of Medicine (Immunology & Rheumatology) at Stanford University School of Medicine
Students:
- Carissa Lee – University of Washington School of Medicine
- Mehr Grewal – University of Washington
Additional Resources & Further Reading
- AAPM&R Guidelines: Cheng AL, Herman E, Abramoff B, et al. Multidisciplinary collaborative guidance on the assessment and treatment of patients with Long COVID: A compendium statement. PM&R. 2025; 17(6): 684-708. doi:10.1002/pmrj.13397
- Younis S, Moutusy SI, Rasouli S, Jahanbani S, Pandit M, Wu X, Acharya S, Sharpe O, Wijeratne TU, Harris ML, Yang EY, Chaichian Y, Parsafar S, Baker MC, Harley JB, Meffre E, Steinman L, Marshak-Rothstein A, James JA, Martinez OM, Utz PJ, Orange DE, Lanz TV, Robinson WH. Epstein-Barr virus reprograms autoreactive B cells as antigen-presenting cells in systemic lupus erythematosus. Sci Transl Med. 2025 Nov 12;17(824):eady0210. doi: 10.1126/scitranslmed.ady0210. Epub 2025 Nov 12. PMID: 41223250; PMCID: PMC12740198.
- Girgis AA, Cimbro R, Yang T, Rebman AW, Sewell T, Villegas de Flores D, Vadalia A, Robinson WH, Cox AL, Darrah E, Soloski MJ, Aucott J. Aberrant T-cell phenotypes in a cohort of patients with post-treatment Lyme disease. Front Immunol. 2025 Jul 9;16:1607619. doi: 10.3389/fimmu.2025.1607619. PMID: 40703523; PMCID: PMC12283721.
- Robinson WH, Younis S, Love ZZ, Steinman L, Lanz TV. Epstein-Barr virus as a potentiator of autoimmune diseases. Nat Rev Rheumatol. 2024 Nov;20(11):729-740. doi: 10.1038/s41584-024-01167-9. Epub 2024 Oct 10. PMID: 39390260.
Self-Assessment
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