{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T20:32:18Z","timestamp":1792528338750,"version":"4.5.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:p>Herpes zoster (HZ) is the clinically apparent manifestation of latent varicella-zoster virus (VZV) reactivation. Aging and immunosuppression are established risk contexts. SARS-CoV-2 infection has prompted renewed attention to whether acute or post-acute immune changes can reduce the reserve needed to maintain VZV latency. Large observational studies report a modest increase in HZ after COVID-19, most consistently after severe disease or hospitalization and within early post-infection windows. These associations do not establish direct causation or a population-wide shift of HZ toward younger adults. A threshold-lowering interpretation is more consistent with the available evidence: SARS-CoV-2 infection may narrow latency-control reserve through cellular immune disruption, interferon dysregulation, and inflammation, particularly in hosts already affected by comorbidity or treatment-related immunosuppression. Long COVID provides a setting in which persistent immune dysregulation can be studied, but it is not yet a proven causal framework for VZV disease. Post-COVID HZ may therefore represent a clinically visible manifestation of disrupted host-virus homeostasis in susceptible individuals. Prospective studies that combine clinical phenotyping with VZV-specific cellular immune measurements are needed to test this model.<\/jats:p>","DOI":"10.3389\/fcimb.2026.1904565","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T12:39:02Z","timestamp":1785933542000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Post-COVID varicella-zoster virus reactivation: lowering the immunological threshold for latency breakdown"],"prefix":"10.3389","volume":"16","author":[{"given":"Xiaolu","family":"Li","sequence":"first","affiliation":[{"name":"Department of Immunology, School of Basic Medical Sciences, Harbin Medical University","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuchang","family":"Cheng","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine, Northeast Agricultural University","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siqi","family":"Wang","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine, Northeast Agricultural University","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaili","family":"Gao","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine, Northeast Agricultural University","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Bai","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine, Northeast Agricultural University","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sainan","family":"Li","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine, Northeast Agricultural University","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingchun","family":"Gao","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine, Northeast Agricultural University","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongli","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Immunology, School of Basic Medical Sciences, Harbin Medical University","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"6776","DOI":"10.1016\/j.vaccine.2019.09.031","article-title":"VZV-specific cell-mediated immunity, but not humoral immunity, correlates inversely with the incidence of herpes zoster and the severity of skin symptoms and zoster-associated pain: the SHEZ study","volume":"37","author":"Asada","year":"2019","journal-title":"Vaccine"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac118","article-title":"Increased risk of herpes zoster in adults \u226550 years old diagnosed with COVID-19 in the United States","volume":"9","author":"Bhavsar","year":"2022","journal-title":"Open Forum Infect. 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