New-onset autoimmune disease after COVID-19

Area of Science:

• Immunology
• Infectious Diseases
• Rheumatology

Background:

• Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can activate the immune system, potentially leading to autoimmune diseases (AD).
• While associations between COVID-19 and new-onset AD have been reported, the specific risks related to different SARS-CoV-2 strains remain unclear.

Purpose of the Study:

• To investigate the incidence and risk of various autoimmune diseases following COVID-19 diagnosis.
• To compare the risk of AD after infection with different SARS-CoV-2 variants.

Main Methods:

• A large cohort of adult patients diagnosed with COVID-19 (January 2020-March 2023) was analyzed using the TriNetX research network.
• Age- and sex-propensity score-matched controls without COVID-19 were used for comparison.
• Patients with pre-existing or immediately post-infection AD were excluded; outcomes were assessed 1 month to 1 year after the index date.

Main Results:

• Higher risks of certain ADs, including cutaneous vasculitis, polyarteritis nodosa, and hypersensitivity angiitis, were observed after COVID-19.
• Psoriasis, rheumatoid arthritis, and type 1 diabetes had the highest incidence, with psoriasis and diabetes showing increased likelihood post-COVID-19.
• The risk of developing AD was lower when COVID-19 was diagnosed during the predominance of Omicron variants. Positive antinuclear antibodies were predictive of AD post-COVID-19.

Conclusions:

• SARS-CoV-2 may act as a trigger for certain autoimmune diseases.
• The risk of developing AD after COVID-19 infection may be reduced with newer variants like Omicron.