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Review
. 2021 Jan 26:11:611318.
doi: 10.3389/fimmu.2020.611318. eCollection 2020.

COVID-19 in Association With Development, Course, and Treatment of Systemic Autoimmune Rheumatic Diseases

Katja Lakota  1   2 , Katja Perdan-Pirkmajer  1   3 , Alojzija Hočevar  1   3 , Snezna Sodin-Semrl  1   2 , Žiga Rotar  1   3 , Saša Čučnik  1   4 , Polona Žigon  1   2
Affiliations
Review

COVID-19 in Association With Development, Course, and Treatment of Systemic Autoimmune Rheumatic Diseases

Katja Lakota et al. Front Immunol. .

Abstract

Autoimmune diseases and infections are often closely intertwined. Patients with autoimmune diseases are more susceptible to infections due to either active autoimmune disease or the medications used to treat them. Based on infections as environmental triggers of autoimmunity, an autoimmune response would also be expected in COVID-19. Although some studies have shown the occurance of autoantibodies and the possible development of autoimmune diseases after SARS-CoV-2 infection, current data suggest that the levels of autoantibodies following SARS-CoV-2 infection is comparable to that of some other known infections and that the autoantibodies might only be transient. The risk of SARS-CoV-2 infection in patients with a systemic autoimmune rheumatic disease (SARD) appears slightly higher compared to the general population and the course of COVID-19 disease does not seem to be very different, however, specific therapies such as glucocorticoids and anti-TNF might modulate the risk of hospitalization/death. Cytokine release syndrome is a severe complication in COVID-19. Many drugs used for the treatment of SARD are directly or indirectly targeting cytokines involved in the cytokine release syndrome, therefore it has been suggested that they could also be effective in COVID-19, but more evidence on the use of these medications for the treatment of COVID-19 is currently being collected.

Keywords: COVID-19; antiphospholipid antibodies; autoantibodies; disease-modifying antirheumatic drugs; incidence; pediatric multisystem inflammatory syndrome in children; systemic autoimmune rheumatic diseases; therapy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Comparison of multisystem inflammatory disease (MIS-C) related to coronavirus disease 2019 (COVID-19) and Kawasaki disease.
Figure 2
Figure 2
Therapy for systemic autoimmune rheumatic disease (SARD) and their possible effect/role in coronavirus disease 2019 (COVID-19).
Figure 3
Figure 3
Graphical summary of SARS-CoV-2 infection and systemic autoimmune diseases. APS, antiphospholipid syndrome; EMA, European Medicine Agency; MIS-C, multisystem inflammatory syndrome in children; SARD, systemic autoimmune rheumatic diseases; SARS CoV-2, severe acute respiratory syndrome coronavirus 2; COVID-19, coronavirus disease.
See this image and copyright information in PMC

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