美国加州大学Esther Melamed课题组的最新研究提出了急性和长期COVID-19病毒再激活。2026年8月5日出版的《自然》杂志发表了这项成果。

利用来自COVID-19队列免疫表型评估（IMPACC）研究的1154名住院COVID-19患者的多组学纵向数据，该研究团队发现急性COVID-19期间疱疹病毒科和无球病毒科的显著再激活，不同病毒主题具有不同的时间动态，并证明再激活与疾病严重程度、宿主免疫效应和临床结果相关。虽然他们的结果没有建立病毒再激活与临床结果之间的相关性，但研究组强调了急性COVID-19和长期COVID-19期间慢性病毒再激活的患病率。

他们的发现挑战了流行的观点，即慢性病毒再激活主要是免疫抑制的结果，表明在严重疾病期间免疫能力强的个体中经常发生再激活，并与全身性炎症增加有关。此外，课题组研究人员证实了恢复期病毒再激活的持久性，并报告了Anelloviridae与长其COVID的关联。该研究提供了病毒再激活的免疫、转录组学和代谢组学特征，可以为未来预测和治疗急性COVID-19和长期COVID-19的策略提供信息。

据悉，慢性病毒感染在人类中是普遍存在的，个体携带多种病毒主题，这些病毒主题可以在生理压力下重新激活，包括严重疾病。值得注意的是，SARS-CoV-2感染已被证明可以重新激活爱泼斯坦-巴尔病毒和巨细胞病毒等慢性病毒主题，但病毒在COVID-19中重新激活的全部程度、时间动态和免疫学影响仍未完全了解。

附：英文原文

Title: Virus reactivation in acute and long COVID-19

Author: Maguire, Cole, Chen, Jing, Rouphael, Nadine, Morse, Brinkley A., Hoch, Annmarie, Pickering, Harry, Phan, Hoang Van, Glascock, Abigail, Chu, Victoria, Dandekar, Ravi, Corry, David, Kheradmand, Farrah, Baden, Lindsey R., Sekaly, Rafick-Pierre, McComsey, Grace A., Haddad, Elias K., Cairns, Charles B., Pulendran, Bali, Fernandez-Sesma, Ana, Simon, Viviana, Metcalf, Jordan P., Agudelo Higuita, Nelson I., Messer, William B., Davis, Mark M., Nadeau, Kari C., Kraft, Monica, Bime, Chris, Schaenman, Joanna, Erle, David, Calfee, Carolyn S., Atkinson, Mark A., Brakenridge, Scott C., Ehrlich, Lauren I. R., Montgomery, Ruth R., Shaw, Albert, Hough, Catherine L., Hafler, David, Augustine, Alison D., Becker, Patrice M., Peters, Bjoern, Ozonoff, Al, Kim-Schulze, Seunghee, Krammer, Florian, Bosinger, Steven E., Eckalbar, Walter, Altman, Matthew C., Wilson, Michael, Guan, Leying, Kleinstein, Steven H., Smolen, Kinga K., Reed, Elaine F., Levy, Ofer, Maecker, Holden, Hunt, Peter, Steen, Hanno, Diray-Arce, Joann, Langelier, Charles R., Melamed, Esther

Issue&Volume: 2026-08-05

Abstract: Chronic viral infections are ubiquitous in humans, with individuals carrying multiple viruses that can reactivate during physiological stress, including severe illness1. Notably, SARS-CoV-2 infection has been shown to reactivate chronic viruses such as Epstein–Barr virus and cytomegalovirus, yet the full extent, temporal dynamics and immunological impact of viral reactivation in COVID-19 remain incompletely understood2,3,4,5,6,7. Here, leveraging multi-omic longitudinal data from 1,154 hospitalized patients with COVID-19 from the Immunophenotyping Assessment in a COVID-19 Cohort (IMPACC) study, we reveal significant reactivation of Herpesviridae and Anelloviridae during acute COVID-19, with distinct temporal dynamics for different viruses, and demonstrate that reactivation correlates with disease severity, host immune effects and clinical outcomes. Although our results do not establish causation between virus reactivation and clinical outcomes, we highlight the prevalence of chronic viral reactivation during acute COVID-19 and long COVID. Our findings challenge the prevailing view that chronic viral reactivation is primarily a consequence of immunosuppression, demonstrating that reactivations occur frequently in immunocompetent individuals during severe illness and in association with increased systemic inflammation. Additionally, we demonstrate persistence of viral reactivation in convalescence, and report an association of Anelloviridae with long COVID. This study provides immune, transcriptomic and metabolomic signatures of viral reactivation that could inform future strategies to prognosticate and treat acute COVID-19 and long COVID.

DOI: 10.1038/s41586-026-10740-z

Source: https://www.nature.com/articles/s41586-026-10740-z