COVID-19 and autoimmune diseases. Review
https://doi.org/10.22625/2072-6732-2025-17-3-41-50
Abstract
Since the beginning of the COVID-19 pandemic, a large amount of data has been accumulated indicating a connection between this new coronavirus infection and the development of autoimmune manifestations in various organs and systems.
The review includes data from foreign and domestic articles published in PubMed over the past 6 years, which are devoted to the role of COVID-19 as a trigger for the occurrence of systemic and organ-specific autoimmune diseases, including hematologic diseases.
The development of autoimmune diseases (AID) after COVID-19 can be triggered by the infection itself, as well as vaccination. The emergence of AID is due to both molecular mimicry and immune dysregulation caused by the SARS-CoV-2 virus. The review provides a description of individual cases of development of different AIDs, as well as the results of a number of cohort observational studies covering a period of 1-2 years, which analyzed large data sets of patients with COVID-19 infection. A unique aspect of AIDs following SARS-CoV-2 infection compared to other previously known viral pathogens is the extremely broad spectrum of conditions observed. The timing of AID manifestation after COVID-19 is characterized by marked variability (from 1 to 15 months). Among the autoimmune blood system diseases, the most common are autoimmune hemolytic anemia (AIH) and immune thrombocytopenic purpura (ITP), which can develop within a few days after infection with the SARS-CoV-2 virus.
About the Authors
T. V. Glazanova
Russian Research institute of hematology and transfusiology
Russian Federation
Competing Interests:
Russian Federation
Saint-Petersburg
Competing Interests:
None
E. V. Kuzmich
Russian Research institute of hematology and transfusiology
Russian Federation
Competing Interests:
Russian Federation
Saint-Petersburg
Competing Interests:
None
I. E. Pavlova
Russian Research institute of hematology and transfusiology
Russian Federation
Competing Interests:
Russian Federation
Saint-Petersburg
Competing Interests:
None
L. N. Bubnova
Russian Research institute of hematology and transfusiology
Russian Federation
Competing Interests:
Russian Federation
Saint-Petersburg
Competing Interests:
None
References
1. Das S, Parul, Samanta M. Autoimmune diseases post-COVID 19 infection in children in intensive care unit: A case series. Int J Rheum Dis. 2023;26:2288-2293. https://doi.org/10.1111/1756-185X.14724
2. Sharma С, Bayry J. High risk of autoimmune diseases after COVID-19. Nature Reviews Rheumatology. 2023;19:399-400. https://doi.org/10.1038/s41584-023-00964-y
3. Dotan A, Muller S, Kanduc D, David P, Halpert G, Shoenfeld Y. The SARS-CoV-2 as an instrumental trigger of autoimmunity. Autoimmun. Rev. 2021;20(4):102792. https://doi.org/10.1016/j.autrev.2021.102792
4. Moody R, Wilson K, Flanagan KL, Jaworowski A, Plebanski M. Adaptive immunity and the risk of autoreactivity in COVID-19. Int. J. Mol. Sci. 2021;22(8965):1-13. https://doi.org/10.3390/ijms22168965
5. Yazdanpanah N, Rezaei N. Autoimmune complications of COVID-19. J. Med. Virol. 2022;94(1):54-62. https://doi.org/10.1002/jmv.27292
6. V’kovski P, Kratzel A, Steiner S, Stalder H, Thiel V. Coronavirus biology and replication: implications for SARS-CoV-2. Nat Rev Microbiol. 2021;19:155-170. https://doi.org/10.1038/s41579-020-00468-6
7. Getts DR, Chastain EM, Terry RL, Miller SD. Virus infection, antiviral immunity, and autoimmunity. Immunol Rev. 2013;255:197-209. https://doi.org/10.1111/imr.12091
8. McMillan P, Dexhiemer T, Neubig RR, Uhal BD. COVID-19-A Theory of Autoimmunity Against ACE-2 Explained. Front Immunol. 2021;12:582166. https://doi.org/10.3389/fimmu.2021.582166
9. Rodriguez L, Brodin P. Unraveling the Immune Response in Severe COVID-19. J Clin Immunol. 2020;40:958-959. https://doi.org/10.1007/s10875-020-00849-9
10. Bajaj V, Gadi N, Spihlman AP, Wu SC, Choi CH, Moulton VR. Aging, Immunity, and COVID-19: How Age Influences the Host Immune Response to Coronavirus Infections? Front Physiol. 2020;11:571416. https://doi.org/10.3389/fphys.2020.571416
11. Kaya F, Alsafdi T, Al-Suleh M. A rare post-infectious autoimmune manifestation of COVID-19. EJCRIM. 2024;11(6):4542. https://doi.org/10.12890/2024_004542
12. Sharma C, Ganigara M, Galeotti C, Burns J, Berganza FM, Hayes DA, et al. Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison. Nat. Rev. Rheumatol. 2021;17:731-748. https://doi.org/10.1038/s41584-021-00709-9
13. Kozlova AO, Eliseeva DD, Simaniv TO, Bryukhov VV, Baidina EV, Zakharova MN. Autoimmune spinal cord lesions associated with novel coronavirus infection. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2022;14(1S):21-28. (In Russ.) https://doi.org/10.14412/2074-2711-2022-1S-21-28
14. Alekseeva T.M., Isabekova P.Sh., Topuzova M.P., Skripchenko N.V. New onset of generalized myasthenia gravis developed after a new coronavirus infection (COVID-19). Journal Infectology. 2021;13(4):127-132. (In Russ.) https://doi.org/10.22625/2072-6732-2021-13-4-127-132
15. Volchkova EA, Legkova KS, Topchy TB. COVID-19 as a trigger of autoimmune hepatitis. Case report. Terapevticheskii Arkhiv (Ter. Arkh). 2022;94(2):259–264. DOI: 10.26442/00403660.2022.02.201374
16. Kolpakova EA, Elfimova AR, Nikankina LV, Dyakov I., Bushkova KK, Troshina EA. COVID-19 and the possible development of autoimmune thyroid diseases. Clinical and experimental thyroidology. 2022;18(3):4-12. (In Russ.) https://doi.org/10.14341/ket12740
17. Milic G, Ristic M, Milosevic M, Mitovic N, Dimitrijevic L, Petrovic T, Salovic B. Post-COVID-19 Syndrome Associated With Multiple Autoimmune Diseases (DM I—LADA, Chronic Autoimmune Thyroiditis and Pernicious Anemia): Case Report. Clinical Medicine Insights: Endocrinology and Diabetes. 2024;17:1-4. https://doi.org/10.1177/117955142412671
18. Son K, Jamil R, Chowdhury A, Mukherjee M, Venegas C, Miyasaki K, et al. Circulating anti-nuclear autoantibodies in COVID-19 survivors predict long COVID symptoms. Eur Respir J. 2023;61(1):2200970. https://doi.org/10.1183/13993003.00970-2022
19. Shimizu H, Matsumoto H, Sasajima T, Suzuki T, Okubo Y, Fujita Y, et al. New-onset dermatomyositis following COVID-19: a case report. Front Immunol. 2022;13:1002329. https://doi.org/10.3389/fimmu.2022.1002329
20. Shen Y, Voigt A, Goranova L, Abed M, Kleiner DE, Maldonado JO, et al. Evidence of a Sjogren’s disease-like phenotype following COVID-19. JCI Insight. 2023;8(24):e166540. https://doi.org/10.1172/jci.insight.166540
21. Chang R, Chang R, Yen-Ting Chen T, Wang SI, Hung YM, Chen HY, Wei CCJ . Risk of autoimmune diseases in patients with COVID-19: A retrospective cohort study. EClinicalMedicine. 2023;56:101783. https://doi.org/10.1016/j.eclinm.2022.101783
22. Tesch F, Ehm F, Vivirito A, Wende D, Batram M, Loser F, et al. Incident autoimmune diseases in association with a SARS-CoV-2 infection: a matched cohort study. Clinical Rheumatology. 2023;42:2905-2914 https://doi.org/10.1007/s10067-023-06670-0
23. Lim SH, Ju HJ, Han JH, Lee JH, Lee WS, Bae JM, Lee S. Autoimmune and Autoinflammatory Connective Tissue Disorders Following COVID-19. JAMA Network Open. 2023;6(10):e2336120. https://doi.org/10.1001/jamanetworkopen.2023.36120
24. Heo YW, Jeon JJ, Ha MC, Kim YH, Lee S. Long-Term Risk of Autoimmune and Autoinflammatory Connective Tissue Disorders Following COVID-19. JAMA Dermatol. 2024 ;160(12):1278-1287. https://doi.org/10.1001/jamadermatol.2024.4233
25. Hileman CO, Malakooti SK, Patil N, Singer NG, McComsey GA. New-onset autoimmune disease after COVID-19. Frontiers in Immunology. 2024;15:1337406. https://doi.org/10.3389/fimmu.2024.1337406
26. Shumnalieva R, Ravichandran N, Hannah J, Javaid M, Darooka N, Roy D, et al. Characteristics of emerging new autoimmune diseases after COVID-19 vaccination: A sub-study by the COVAD group. Int J Rheum Dis. 2024;27:e15178. https://doi.org/10.1111/1756-185X.15178
27. Alqatari S, Ismail M, Hasan M, Bukhari R, Al Argan R, Alwaheed A, Alkhafaji D. Emergence of Post COVID-19 Vaccine Autoimmune Diseases: A Single Center Study. Infection and Drug Resistance. 2023;16:1263-1278. https://doi.org/10.2147/IDR.S394602
28. Seung-Won J, Jae JJ, You HK, Sung JC, Solam L. Long-term risk of autoimmune diseases after mRNA-based SARS-CoV2 vaccination in a Korean, nationwide, population-based cohort study. Nature Communications. 2024;15:6181. https://doi.org/10.1038/s41467-024-50656-8
29. Peng K, Li X, Yang D, Chan S, Zhou J, Wan E, et al. Risk of autoimmune diseases following COVID-19 and the potential protective effect from vaccination: a population based cohort study. eClinicalMedicine. 2023;63:102154. https://doi.org/10.1016/j.eclinm.2023.102154
30. Tang KT, Hsu BC, Chen DY. Autoimmune and rheumatic manifestations associated with COVID-19 in adults: an updated systematic review. Front Immunol. 2021;12:645013. https://doi.org/10.3389/fimmu.2021.645013
31. Barcellini W, Zaninoni A, Giannotta JA, Fattizzo B. New insights in autoimmune hemolytic anemia: from pathogenesis to therapy. J Clin Med. 2020; 9:3859. https://doi.org/doi:10.3390/jcm9123859
32. Kakavandi S, Hajikhani B, Azizi P, Aziziyan F, Nabi-Afjadi M. COVID-19 in patients with anemia and haematological malignancies: risk factors, clinical guidelines, and emerging therapeutic approaches. Cell Communication and Signaling. 2024;22:126. https://doi.org/10.1186/s12964-023-01316-9
33. Lazarian G, Quinquenel A, Bellal M, Siavellis J, Jacquy C, Re D, et al. Autoimmune haemolytic anaemia associated with COVID-19 infection. British Journal of Haematology. 2020;190:29-31. https://doi.org/10.1111/bjh.16794
34. Coz J, Patel K, Fera B. Chilling complications: COVID associated cold autoimmune hemolytic anemia (AIHA). CHEST 2024 Annual Meeting Abstracts. https://doi.org/10.1016/j.chest.2024.06.1596
35. Kimura H, Furukawa M, Shiga Y, Kai T, Yasuda I, Katoh S, Sando E. Exacerbation of autoimmune hemolytic anemia associated with pure red cell aplasia after COVID-19: A case report. Journal of Infection and Chemotherapy. 2023;29:787-791. https://doi.org/10.1016/j.jiac.2023.04.002
36. Safuanova GSh, Konstantinova AS, Latypova AA, Bagautdinova AU, Safuanova DR. A Clinical Case of Aplastic Anemia After COVID-19 Infection. The Russian Archives of Internal Medicine. 2021;11(6):466-471. https://doi.org/10.20514/2226-6704-2021-11-6-466-471
37. Russotto Y, Micali C, Marino A, Ceccarelli M, Caci G, Rullo E, Nunnari G. COVID-19 infection and severe autoimmune haemolytic anaemia: A case report and review of the literature. World Academy Of Sciences Journal. 2023;5(6):31. https://doi.org/10.3892/wasj.2023.208
38. Taherifard E, Taherifard E, Movahed H, Mousavi M. Hematologic autoimmune disorders in the course of COVID-19: a systematic review of reported cases. Hematology. 2021;26(1):225-239. https://doi.org/10.1080/16078454.2021.1881225
Review
For citations:
Glazanova T.V., Kuzmich E.V., Pavlova I.E., Bubnova L.N. COVID-19 and autoimmune diseases. Review. Journal Infectology. 2025;17(3):41-50. (In Russ.) https://doi.org/10.22625/2072-6732-2025-17-3-41-50
Views:
354
.png)
.png)
Email this article 