Shady, Eslam Farid Abu, Ghallab, Abdelhakim Fouad, Shaker, Doaa Abdullah et al. · Auris, nasus, larynx · 2025 · DOI
This study looked at whether a virus called Epstein-Barr virus (EBV) wakes up again in people who have prolonged COVID symptoms like fatigue. Researchers compared 140 people with ongoing COVID fatigue to 80 people who fully recovered from COVID. They found that EBV was reactivated in about 29% of people with persistent fatigue compared to 11% of those who recovered, suggesting EBV reactivation might play a role in long COVID.
For ME/CFS and long COVID research, identifying viral reactivation as a potential driver of fatigue and post-exertional malaise could open new therapeutic avenues using antiviral approaches. This finding bridges two conditions that share overlapping symptom profiles and may help explain why some people develop prolonged fatigue after acute infection.
This study does not prove that EBV reactivation *causes* post-COVID fatigue—it shows correlation, not causation. The study also does not establish EBV reactivation as the sole mechanism of long COVID, nor does it validate EBV inhibitors as effective treatments; the authors only suggest this as a potential approach. Additionally, the cross-sectional design cannot determine whether EBV reactivation preceded or followed the onset of persistent symptoms.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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