COVID-19 and SLE: Infection and autoimmunity at its best

Area of Science:

• Immunology
• Infectious Diseases
• Rheumatology

Background:

• The COVID-19 pandemic highlighted a strong correlation between infections and autoimmunity.
• Immune and autoimmune reactions observed in SARS-CoV-2 infected patients support this link.
• COVID-19 vaccines, while generally safe, are also postulated to potentially induce autoimmune reactions.

Purpose of the Study:

• To examine the connection between SARS-CoV-2 infection, COVID-19 vaccination, and systemic lupus erythematosus (SLE).
• To review available data on new-onset SLE, SLE exacerbations, and related conditions following infection and vaccination.

Main Methods:

• Review of recent literature and available data.
• Analysis of reported cases of SLE in relation to SARS-CoV-2 infection and vaccination.
• Exploration of postulated mechanisms linking vaccines to autoimmune responses.

Main Results:

• Increased rates of SARS-CoV-2 infection observed in patients with pre-existing SLE.
• Documented cases of new-onset SLE following COVID-19 infection.
• Reports of mRNA and adenovirus-vector vaccines inducing new SLE cases, triggering immune thrombocytopenia or lupus nephritis, and exacerbating SLE flares.

Conclusions:

• Both SARS-CoV-2 infection and COVID-19 vaccination are significant considerations for patients with SLE.
• The potential for vaccines to induce or worsen autoimmune conditions like SLE warrants further investigation.
• Understanding these associations is crucial for managing SLE patients during and after the pandemic.