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COVID-19 and Autoimmune Diseases: A Systematic Review of Reported Cases
Mariam Ahmed Saad1, Mostafa Alfishawy2, Mahmoud Nassar3
1Medical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
Insights
Coronavirus disease 2019 (COVID-19) can trigger autoimmune diseases in patients. This review found Guillain-Barré syndrome and autoimmune hemolytic anemia were among the most common manifestations following COVID-19 infection.
Area of Science:
- Immunology
- Infectious Diseases
- Neurology
Background:
- The COVID-19 pandemic has seen over 4.9 million confirmed cases globally.
- Emerging evidence suggests a link between COVID-19 and autoimmune manifestations.
- This review examines reported cases of COVID-19 associated with autoimmune diseases.
Observation:
- A systematic search of the PubMed database identified 20 eligible studies published in English between January 1st and May 22nd, 2020.
- These studies reported on 33 confirmed COVID-19 cases who developed autoimmune diseases post-infection.
- Patient ages ranged from 6 months to 89 years, with a mean age of 53.9 years.
Findings:
- The time between viral symptom onset and autoimmune manifestation averaged 9.8 days.
- Reported autoimmune diseases included subacute thyroiditis, Kawasaki Disease, coagulopathy, antiphospholipid syndrome, immune thrombocytopenic purpura, autoimmune hemolytic anemia, and Guillain-Barré syndrome.
- Guillain-Barré syndrome (48.5%) and autoimmune hemolytic anemia (24.2%) were the most frequent post-COVID-19 autoimmune conditions.
Implications:
- COVID-19 is implicated in the development of various autoimmune diseases.
- Findings highlight the potential connection between viral infections and the onset of autoimmune conditions.
- Further research is warranted to understand the mechanisms underlying COVID-19-induced autoimmunity.
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 keywords 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 abstracts. All reports of confirmed COVID-19 patients who have associated clinical evidence of autoimmune disease were selected.
Results:
Among the 10006 articles, searches yielded thirty-two relevant articles for full-text assessment. Twenty studies has met 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%).
Conclusion:
COVID-19 has been implicated in the development of a range of autoimmune diseases, which may shed light on the association between autoimmune diseases and infections.
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