Risk of Autoimmune Rheumatic Diseases following COVID-19: A Systematic Review and Meta-Analysis.

Area of Science:

• Rheumatology
• Infectious Diseases
• Immunology

Background:

• Growing reports link COVID-19 (coronavirus disease 2019) to new-onset autoimmune rheumatic diseases.
• The precise impact of SARS-CoV-2 infection on the incidence of these conditions requires systematic evaluation.

Purpose of the Study:

• To systematically determine if COVID-19 influences the incidence of autoimmune rheumatic diseases.
• To quantify the risk of developing specific autoimmune rheumatic conditions post-SARS-CoV-2 infection.

Main Methods:

• Comprehensive literature search of MEDLINE (PubMed), Global Index Medicus, and Cochrane Library up to March 30, 2024.
• Inclusion of eight cohort studies involving over 5.5 million COVID-19 patients and 18.4 million non-COVID-19 controls.
• Pooled analysis to assess the relative risk (RR) of autoimmune rheumatic diseases following SARS-CoV-2 infection.

Main Results:

• COVID-19 patients showed a 168% increased risk of mixed connective tissue disease (RR: 2.68) and a 101% increased risk of Behçet's disease (RR: 2.01).
• A 45% increased risk was observed for rheumatoid arthritis (RR: 1.45) and psoriasis (RR: 1.45), and a 40% increase for dermatopolymyositis (RR: 1.40).
• Non-significant risk increases were noted for ankylosing spondylitis, systemic lupus erythematosus, systemic sclerosis, Sjögren's syndrome, and polymyalgia rheumatica.

Conclusions:

• COVID-19 is associated with an elevated risk of several autoimmune rheumatic diseases, particularly within the first year post-infection.
• The findings underscore a significant link between SARS-CoV-2 infection and the development of specific autoimmune conditions.
• High inter-study heterogeneity necessitates cautious interpretation of the results.