Unraveling Interconnected Dynamics: Herpes Zoster, Postherpetic Neuralgia, and COVID-19 – A Bidirectional Mendelian Randomization Analysis

Abstract Objective: The COVID-19 pandemic has seen an increase in the number of patients experiencing herpes zoster (HZ) and postherpetic neuralgia (PHN), yet the association between these two conditions remains unclear. This study aims to investigate the causal relationship between SARS-CoV-2 infection and HZ as well as PHN, providing guidance for clinical intervention. Methods: Employing Mendelian randomization to minimize bias at the methodological level, we conducted bidirectional Mendelian randomization to investigate pathogenic associations between diseases. Our research focused on the disease genetic data related to HZ and PHN within European populations sourced from FinnGen. Additionally, we utilized the severity and susceptibility phenotype data of COVID-19 from the largest GWAS dataset of COVID-19 as integral components of our investigation. Results: Our study revealed that HZ may contribute to the onset of COVID-19, whereas COVID-19 does not elevate the susceptibility to HZ, and there is no apparent causal relationship between PHN and COVID-19. Conclusion: The findings from this study suggest that the activation of varicella-zoster virus (VZV) may heighten the susceptibility of patients to COVID-19. These insights play a crucial role in guiding the development of more effective clinical intervention strategies, especially in the context of preventing COVID-19 among patients with HZ.