L‐lysine in herpesvirus reactivation after ChAdOx1 nCoV‐19 vaccine (AZD1222): Minor literature review and case report
Abstract
Dear Editor, With the expansion of vaccines for various age groups, the panic has been reduced and economic activities were resumed. The ChAdOx1-nCoV-19 (AZD1222-Oxford-AstraZeneca) vaccine has acceptable safety in adults over 18 years of age. It is effective in preventing COVID-19, but it can trigger reactivation of latent viruses such as herpesviruses, particularly HHV-6/7 causing pityriasis rosea and HHV-1/2 causing herpes simplex. A 60-year-old male, carrier a latent HHV-1, without COVID-19 diagnosis or symptoms, received the first and second doses of AZD1222 vaccine. After 7 days of the first and second dose, he presented painful, burning palatal edema and an upper lip edema suggestive of herpetic labial lesion (Figure 1A,B), in the same location as previous episodes 2 years before the vaccine. The patient immediately received 3 g of L-lysine in a single dose (before 24 h) and 500 mg/ day, fasting, for 30 days as well as control the intake of acidic foods or with a lot of arginine (chocolate, peanuts, cashew, almonds, and coffee). In 36 h, the symptoms were controlled and the lip and palate lesions had remission. The diagnosis was HHV-1 reactivation caused by the AZD1222 vaccine. An international registry showed a considerable increase in herpes simplex cases post vaccination. The initial five cases were recorded after Moderna or Pfizer-BioNTech vaccines. The manifestations onset was between 7 and 13 days from vaccination until the first symptom. Four cases occurred…
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