text: Investigation of Long COVID Prevalence and Its Relationship to Epstein Barr Virus Reactivation Coronavirus disease 2019 COVID 19 patients sometimes experience long term symptoms following resolution of acute disease including fatigue brain fog and rashes Collectively these have become known as long COVID Our aim was to first determine long COVID prevalence in 185 randomly surveyed COVID 19 patients and subsequently to determine if there was an association between occurrence of long COVID symptoms and reactivation of Epstein Barr virus EBV in 68 COVID 19 patients recruited from those surveyed We found the prevalence of long COVID symptoms to be 30 3 56 185 which included 4 initially asymptomatic COVID 19 patients who later developed long COVID symptoms Next we found that 66 7 20 30 of long COVID subjects versus 10 2 20 of control subjects in our primary study group were positive for EBV reactivation based on positive titers for EBV early antigen diffuse EA D IgG or EBV viral capsid antigen VCA IgM The difference was significant i p i 0 001 Fishers exact test A similar ratio was observed in a secondary group of 18 subjects 21 90 days after testing positive for COVID 19 indicating reactivation may occur soon after or concurrently with COVID 19 infection These findings suggest that many long COVID symptoms may not be a direct result of the SARS CoV 2 virus but may be the result of COVID 19 inflammation induced EBV reactivation 