期刊
CURRENT OPINION IN RHEUMATOLOGY
卷 33, 期 2, 页码 155-162出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/BOR.0000000000000776
关键词
autoimmune diseases; COVID-19; cross-reactivity; molecular mimicry; SARS-CoV-2
类别
资金
- National Natural Science Foundation for Young Scientists of China [81502732]
- National Institutes of Health (NIH) [R01AI097134, R01AR070148]
- Lupus Research Alliance
- urgent grant of Hunan Province for fighting against coronavirus disease-2019 epidemic [2020SK3005]
This study evaluates the association between SARS-CoV-2 infection and autoimmunity, highlighting similarities between COVID-19 and autoimmune diseases in immune responses and potential development of autoimmune conditions. Patients with COVID-19 may develop autoimmune diseases post-infection, emphasizing the importance of medication adherence in preventing disease flares.
Purpose of review The aim of this study was to evaluate the relationship between infection with SARS-CoV-2 and autoimmunity. Recent findings Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome (SARS) associated coronavirus 2 (SARS-CoV-2). Although most of the infected individuals are asymptomatic, a proportion of patients with COVID-19 develop severe disease with multiple organ injuries. Evidence suggests that some medications used to treat autoimmune rheumatologic diseases might have therapeutic effect in patients with severe COVID-19 infections, drawing attention to the relationship between COVID-19 and autoimmune diseases. COVID-19 shares similarities with autoimmune diseases in clinical manifestations, immune responses and pathogenic mechanisms. Robust immune reactions participate in the pathogenesis of both disease conditions. Autoantibodies as a hallmark of autoimmune diseases can also be detected in COVID-19 patients. Moreover, some patients have been reported to develop autoimmune diseases, such as Guillain--Barre syndrome or systemic lupus erythematosus, after COVID-19 infection. It is speculated that SARS-CoV-2 can disturb self-tolerance and trigger autoimmune responses through cross-reactivity with host cells. The infection risk and prognosis of COVID-19 in patients with autoimmune diseases remains controversial, but patient adherence to medication regimens to prevent autoimmune disease flares is strongly recommended. We present a review of the association between COVID-19 and autoimmune diseases, focusing on similarities in immune responses, cross-reactivity of SARS-CoV-2, the development of autoimmune diseases in COVID-19 patients and the risk of COVID-19 infection in patients with preexisting autoimmune conditions.
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