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bioRxiv · 10.64898/2026.08.17.745245

EBV Reprograms B Cells in an Autoimmune-Like Fashion in Patients with COVID-19

Chen, D. G.·Yuan, D.·Su, Y.·Magis, A.·Chu, H.·Goldman, J. D.·Heath, J. R.
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Abstract

Epstein-Barr virus (EBV) reprograms B cells in autoimmune disease. Reprogrammed EBV+ B cells activate nearby B and CD4+ T cells, via upregulated antigen presentation and costimulatory machinery, to drive autoimmune pathology. EBV reactivation is a known correlate of long COVID, which is a heterogeneous condition that can bear similarities to autoimmune disease. However, the mechanisms underpinning this association remain unresolved. We report on EBV metabolically reprogrammed B cells in patients with COVID-19. We find EBV+ B cells provide stimulatory signals to bystander B and CD4+ T cells. SARS-CoV-2 infected participants exhibiting elevated fractions of EBV+ B cells present, at convalescence, with dysregulated lipid profiles, increased autoantibody titers, and post-acute symptomology likely reflective of this metabolic reprogramming and cell-cell interactions. Enrichment of our EBV+ B cell signatures seen in patients with COVID-19 is similar in patients with lupus and multiple sclerosis suggesting a potentially shared pathway of EBV-driven dysfunction across diseases.

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Chen, D. G., Yuan, D., Su, Y., Magis, A., Chu, H., Goldman, J. D., Heath, J. R.. 2026-08-18. EBV Reprograms B Cells in an Autoimmune-Like Fashion in Patients with COVID-19. https://doi.org/10.64898/2026.08.17.745245

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