# Analysis of CMV and EBV infection in healthy populations in China before and after the COVID-19 pandemic

## TL;DR

This study examines CMV and EBV infection rates in healthy Chinese populations before and after the end of strict COVID-19 restrictions, finding higher antibody levels and increased EBV reactivation after restrictions were lifted.

## Contribution

The study reveals a significant rise in EBV IgM positivity after pandemic restrictions were lifted, particularly in adults, suggesting a novel link between SARS-CoV-2 and EBV reactivation.

## Key findings

- CMV and EBV IgG positivity rates were high (94.52% and 95.40%) in healthy donors over 10 years.
- After pandemic restrictions ended, EBV IgM positivity increased significantly, especially in the first 3 months.
- Post-pandemic, SARS-CoV-2 infection was an independent risk factor for EBV reactivation in adults.

## Abstract

评估中国近10年健康人群巨细胞病毒（CMV）和EB病毒（EBV）感染情况，分析新型冠状病毒（以下简称新冠）感染疫情管控全面解除（以下简称解控）前后健康人群CMV和EBV感染情况的差异。

对2014年1月至2023年12月在北京大学人民医院进行造血干细胞移植前检查的8 827名健康移植供者的CMV和EBV的感染情况进行回顾性分析。运用Logistic回归分析CMV和EBV感染的危险因素。

8 827名健康移植供者中CMV和EBV的免疫球蛋白（Ig）G阳性率分别为94.52％和95.40％，显示出较高的既往感染率。CMV与EBV的既往感染率在解控前后差异无统计学意义（CMV：94.63％对93.92％，P＝0.250；EBV：95.36％对95.62％，P＝0.670），但既往感染人群IgG平均抗体滴度有所上升［CMV：（100.44±36.50）U/ml对（109.98±36.31）U/ml，P<0.001；EBV：（281.57±226.79）U/ml对（361.08±268.58）U/ml，P<0.001］。新冠疫情解控前后CMV IgM阳性率变化不显著，但EBV IgM阳性率升高（2.77％对6.29％，P<0.001），尤其解控3个月内EBV IgM阳性率达8.10％。进一步分析影响EBV IgM阳性率的因素，结果显示总体人群中性别（OR＝1.479，95％ CI 1.169～1.872，P＝0.001）、年龄［与<18岁组相比，18～50岁组（OR＝0.584，95％ CI 0.421～0.820，P＝0.002），>50岁组（OR＝0.389，95％ CI 0.248～0.610，P<0.001）］、新冠疫情解控（OR＝2.360，95％ CI 1.287～3.047，P<0.001）均是EBV IgM阳性的独立危险因素；按年龄段分组，<18岁组EBV IgM阳性率不受性别和新冠疫情解控影响，18～50岁组中性别（OR＝1.499，95％ CI 1.138～1.975，P＝0.004）和新冠疫情解控（OR＝2.608，95％ CI 1.940～3.507，P<0.001）均是EBV IgM阳性的独立危险因素，>50岁组中新冠疫情解控是EBV IgM阳性的独立危险因素（OR＝2.222，95％ CI 1.101～4.484，P＝0.026）。

中国健康人群CMV和EBV的既往感染率高，随着年龄增长感染率有所增加。新冠感染可能增加健康人群EBV激活率，其中18岁以上人群新冠感染对EBV激活率的影响更为显著。