Relationships Among Maternal Epstein-Barr Virus Antibodies, COVID-19, and Stress in Mothers up to 1-Year Postpartum.

Publication date: Jun 01, 2026

Both psychosocial stress and current infection can increase the likelihood of reactivation of latent Epstein-Barr virus (EBV). Pregnancy and infection with SARS-CoV-2 can be stressful and modulate immune function. However, it is unknown how SARS-CoV-2 infection and stress further interact among postpartum women to affect EBV antigen and antibody expression. We examined associations among COVID-19 diagnosis, self-reported stress, and EBV immunoglobulin G (IgG) in previously collected data from 45 breastfeeding US women (1-18 months postpartum) during the height of the COVID-19 pandemic. Between June 2020 and March 2021, stress survey data and capillary dried blood HemaSpot samples were collected from 25 SARS-CoV-2 infected and 20 non-infected participants at multiple time points over the course of 60 days. Samples (N = 104) were later assayed for EBV IgG. Statistical methods were pre-registered, and relationships among SARS-CoV-2 infection, stress, and EBV IgG were analyzed via mixed-effects regression models, adjusting for time postpartum and time elapsed since enrollment. There was a statistically significant association between self-reported stress and EBV IgG levels, with higher average stress associated with higher average EBV IgG. EBV IgG relative concentration did not vary independently with COVID-19 positivity status or the number of COVID-19 symptoms. Results suggest that EBV IgG relative concentrations were elevated across sample participants by stress, but not by the relatively mild cases of COVID-19 the mothers experienced.

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