Clinical relevance of circulating blood microaggregates and reactivation of Epstein Barr Virus in long-term Post-CoVID syndrome patients, 2026, Wick+

[forestglip]

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

Spoiler: Authors

Wick, Nikolaus; Hermann, M.; Lisch, Christoph; Gerth, Regine; Wick, Georg; Untersmayr, Eva; Marth, Tatjana; Bachler, Mirjam; Fries, Dietmar

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.

Web | DOI | PDF | Scientific Reports | Open Access

 

[Murph]

Not sure about the retrospective patient analysis nor the EBV stuff, but the blood microscopy looks like a good contribution to step-by-step science, they clearly describe what they did and what they saw. Allowing anyone else to see if they can replicate.

As described previously, we performed live
confocal fluorescence microscopy of native, i.e., unfixed, blood samples to detect free-floating
cellular aggregates under unperturbed conditions (Fig. 1A, [23]). We could observe globular
structures of 100-200 μm diameter that contained leukocytes and acellular material staining
positively for carbohydrate residues, as visualized by the N-acetylglucosamine and N-
acetylneuraminic acid (sialic acid) residues binding lectin wheat germ agglutinin (WGA). As
proven by nuclear fluorescent staining, leukocytes were mainly granulocytes with polymorphic
nuclear shapes, in addition to mononuclear cells. Microaggregates were stable upon overnight
incubation. Regularly, microaggregates attached firmly to the plate surface (video as Online
Resource 1). Importantly, microaggregates also included thrombocytes with a tendency to build
a coverage on the microaggregate surface

Having these aggregates floating around might become a marker for a subset and help define what we are looking at.

 

[Jonathan Edwards]

I would be wary that this is another artifact. If aggregates of this sort really occur and are responsible for 'impeding capillary blood flow' then there should be clinical signs - spinter haemorrhages and other petechiae. Something of this size would completely block an arteriole rather than get to a capillary. I have not seen any reports of splinter haemorrhage Post-Covid.