Aggravated multiple organ injury in patients co-infected with Hantavirus and Epstein-Barr virus in China

Background: To investigate the clinical features of the co-infection of EBV in patients with HFRS caused by hantaviruses. Methods: The HFRS patients were confirmed by detection of IgM antibody in Qingdao, eastern China from December 2019 to July 2022. And EBV infection was determined by detecting IR1gene of EBV by PCR. According to whether EBV was co-infected with or not, all HFRS cases included were divided into EBV group and Non-EBV group. Result: 126 cases admitted for HFRS were included in our studies, with 62 cases in EBV group and 64 cases in Non-EBV group. The incidence of dizzeiness (31/62 VS 17/64), anorexia (59/62 VS 53/64), diarrhea (31/62 VS 10/64), and water stool (26/62 VS 8/64) were significantly higher in HFRS patients co-infected with EBV. Based on the the mean values of outliers in indexes of lab findings from disease onset to 31st day, the more aggravated liver damage, kidney failure, heart injury, hypothyroidism, coagulation disorder, immune dysfuntion, the hypereosinophilic syndrom and megaloblastic anemia occurred in HFRS patients co-infected with EBV. Conclusions: In conclusion, HFRS patients co-infected with EBV were more susceptible to the dysfunction of the neural and alimentary systems and even being invovled in multiple organ systems.