Abstract

HERPES ZOSTER IN THE CONTEXT OF THE SARS-COV-2 PANDEMIC: MULTIPLE TRIGGERS FOR A LATENT INFECTION

Antonio Neres Norberg*, Paulo Roberto Blanco Moreira Norberg, Cláudia Maria Blanco Moreira Norberg, Fernanda Castro Manhães, Bianca Magnelli Mangiavacchi, Fabiano Guerra Sanches, Alcemar Antônio Lopes de Matos and Renato Mataveli Ferreira Filho

ABSTRACT

Herpes zoster is a disease caused by the reactivation of the varicella-zoster virus. The primary infection is called chickenpox, affects mainly children and is very contagious. In some individuals, this virus can remain latent in the nerves of the dorsal root ganglia waiting for an opportunity to return to activity when the physiological conditions of the host become favourable. This manuscript aims to investigate from a syndemic perspective how the pandemic context influences the resurgence of the herpes zoster virus in SARS-COV-2 infected, uninfected and recovered from COVID-19 individuals. Although several researches indicate an increased incidence of herpes zoster in the pandemic context of COVID-19, there are no comprehensive studies on the correlation between the resurgence of the latent varicella-zoster virus infection in this setting. Conditions such as altering daily routine, stress, anxiety, the development of sedentary habits and consequent physiological imbalances are predisposing factors both for infection when exposed to SARS-CoV-2 and for the decrease in immunity responsible for the pathogenic reactivation of the latent varicella-zoster virus. There is evidence that viral infections caused by the new coronavirus may trigger activation of latent herpesviruses, as well as the immunodepression, immunomodulatory and anti-inflammatory drug therapy used in the clinical management of severe cases of COVID-19. Researches reveal that reactivation of the varicella-zoster virus can occur following the vaccination against COVID-19. Most cases of herpes zoster in simultaneous infection or activated after COVID-19 infection or treatment presented typical forms of the disease. The same pattern was observed in virus reactivation following COVID-19 vaccination.

Keywords: COVID-19, SARS-CoV-2, varicella-zoster virus, herpes zoster, syndemic.