Systemic lupus erythematosus after coronavirus disease-2019 (COVID-19) infection: Case-based review

Area of Science:

• Immunology
• Infectious Diseases
• Rheumatology

Background:

• Coronavirus disease-2019 (COVID-19) is a novel infectious disease with diverse clinical presentations.
• Emerging evidence suggests a link between COVID-19 and the development of autoimmune conditions.
• This case report focuses on the association between COVID-19 infection and the onset of systemic lupus erythematosus (SLE).

Purpose of the Study:

• To present a case demonstrating the association between COVID-19 infection and the subsequent development of SLE.
• To highlight the clinical manifestations and diagnostic findings in a patient with COVID-19-induced SLE.
• To review similar cases and identify common patterns of SLE presentation post-COVID-19.

Main Methods:

• A case report of a 38-year-old woman presenting with SLE symptoms 18 days after confirmed COVID-19.
• Diagnostic workup included serological tests (ANA, anti-dsDNA, P-ANCA) and imaging (CT scans).
• Literature review of similar cases to determine the interval between COVID-19 and SLE onset, and common clinical features.

Main Results:

• The patient exhibited symptoms including jaundice, chest pain, dyspnea, photosensitivity, and arthralgia post-COVID-19.
• Laboratory tests revealed positive ANA, anti-dsDNA, and P-ANCA antibodies.
• The patient was diagnosed with SLE and showed significant improvement with immunosuppressive therapy (prednisolone, hydroxychloroquine, mycophenolate mofetil).
• Review of similar cases indicated a mean interval of 24.86 days between COVID-19 symptoms and SLE presentation, with pulmonary and renal involvement being most common.

Conclusions:

• Awareness of potential SLE development in COVID-19 patients is essential.
• Prompt diagnosis and timely treatment of SLE in the context of COVID-19 infection are critical for improving patient prognosis.
• This association underscores the complex interplay between viral infections and autoimmune disease pathogenesis.