COVID-19 and Autoimmune Diseases: A Systematic Review of Reported Cases

Abstract

Introduction: Over 4.9 million cases of Coronavirus disease 2019 (COVID-19) have been confirmed since the worldwide pandemic began. Since the emergence of COVID-19, a number of confirmed cases reported autoimmune manifestations. Herein, we reviewed the reported COVID-19 cases with associated autoimmune manifestations. Methods: We searched PubMed database using all available keyword for COVID-19. All related studies between January 1st, 2020 to May 22nd, 2020 were reviewed. Only studies published in English language were considered. Articles were screened based on titles and abstract. All reports of confirmed COVID-19 patients who have associated clinical evidence of autoimmune disease were selected. Results: Among 10006 articles, searches yielded, Thirty-two relevant articles for full-text assessment. Twenty studies meet the eligibility criteria. The twenty eligible articles reported 33 cases of confirmed COVID-19 diagnosis who developed an autoimmune disease after the onset of covid-19 symptoms. Ages of patients varied from a 6 months old infant to 89 years old female (Mean=53.9 years of 28 cases); five cases had no information regarding their age. The time between symptoms of viral illness and onset of autoimmune symptoms ranged from 2 days to 33 days (Mean of the 33 cases=9.8 days). Autoimmune diseases were one case of subacute thyroiditis (3%), two cases of Kawasaki Disease (6.1%), three cases of coagulopathy and antiphospholipid syndrome (9.1%), three cases of immune thrombocytopenic purpura (9.1%), eight cases of autoimmune hemolytic anemia (24.2%), and sixteen cases of Guillain–Barré syndrome (48.5%). Conclusions: COVID-19 has been implicated in the development in a range of autoimmune diseases which may shed a light on the association between autoimmune diseases and infections.

Immune-Mediated Disease Flares or New-Onset Disease in 27 Subjects Following mRNA/DNA SARS-CoV-2 Vaccination

“…Of note, these manifestations are generally seen in subjects with minimal or not lung disease pointing towards a hyperactive immune response which, while being protective against pneumonia, can lead to collateral damage to other organ systems. Natural infection has also been associated with case reports of vasculitis, neurological disease including GBS and others in addition to other occasionally reported IMDs [ 45 , 46 , 47 ]. Herein, we report a wide variety of vaccine-associated flares or new-onset in IMDs ranging from autoinflammatory, mixed pattern disease (BD) and autoimmune diseases rather than an enrichment in autoimmune diseases that are linked to disordered nucleic acid metabolism and abnormal interferon-stimulated gene signatures involving the TLR-7/9 pathways [ 43 ].…”

The intersection of COVID-19 and autoimmunity: What is our current understanding?

“…A recent study sought to investigate this relationship between SARS-CoV-2 and GBS in the UK, and found that the incidence of GBS had declined during the pandemic, suggesting that SARS-CoV-2 is either not a trigger for GBS in this population, or it is causing fewer cases than are being prevented by the lockdown and new hygiene practices [67]. However, the ability of viral infections to trigger autoimmunity, reports of molecular mimicry between SARS-CoV-2 and human tissues [68], and onset of autoimmunity within a month of first COVID symptoms [66] suggest SARS-CoV-2 may be etiologic for other types of IMIDs, or for GBS in other genetic backgrounds. At present, insufficient data exist to delineate a role of COVID-19 in triggering new onset IMIDs.…”

“…In addition to autoreactive antibodies, there are also case reports of clinical autoimmune diseases post SARS-CoV-2 infection, including autoimmune cytopenia, immune thrombocytopenic purpura, Guillain-Barre syndrome (GBS), Miller Fisher syndrome, and acute disseminated encephalomyelitis [8,66]. While these case reports are informative, they are limited by reporting bias, and it is difficult to determine if these patients would have otherwise developed IMIDs without SARS-CoV-2 infection, and therefore whether these findings are coincidence, rather than causation.…”

Aminodihydrophthalazinedione sodium in prevention, therapy and rehabilitation of patients with respiratory diseases

“…Кроме того, по мере прогрессирования пандемии COVID-19 появлялись различные сообщения о развитии аутоиммунных заболеваний после того, как инфекция взята под контроль [48,49]. Так, после попадания в эпителиальные клетки респираторного тракта коронавируса SARS-CoV-2, вызывающего заболевание, у некоторых пациентов наблюдается тяжелое состояние, связанное с гиперергическим воспалением и обозначаемое как цитокиновый шторм, а также развитие тромботических явлений.…”