COVID-19 Diagnosis Linked to Elevated Risk for Autoimmune and Autoinflammatory Connective Tissue Disorders

According to study results published in JAMA Network OPEN, a previous COVID-19 diagnosis was associated with an elevated risk for autoimmune and autoinflammatory connective tissue disorders.

Researchers conducted a retrospective cohort study between October 8, 2020, and December 31, 2021, including patients diagnosed with COVID-19 through polymerase chain reaction testing, and a control group with no indication of COVID-19.

They reported on the occurrence of and risk associated with autoimmune and autoinflammatory connective tissue disorders following a COVID-19 diagnosis.

The frequency of disease occurrence was assessed by identifying individuals who had at least 3 medical visits with a corresponding diagnostic code.

The COVID-19 group consisted of 354,527 individuals with a mean follow-up time of 119.70 days, while the control group comprised 6,134,940 individuals with a mean follow-up time of 121.40 days.

The mean age of the COVID-19 group was 52.24 years and 50.50% (179,041 patients) were women. The mean age of the control group was 52.05 years and 50.12% (3,074,573 patients) were women.

Other patient demographics were well balanced across both groups.

Patients with COVID-19 were at slightly increased risk for alopecia areata (adjusted hazard ratio [aHR], 1.12; 95% CI,1.05-1.19) and a significantly increased risk for alopecia totalis (aHR, 1.74; 95% CI, 1.39-2.17).

Increased risk for antineutrophil cytoplasmic antibody–associated vasculitis was also associated with a COVID-19 diagnosis (aHR, 2.76; 95% CI, 1.64-4.65), as was Crohn disease (aHR, 1.68; 95% CI, 1.31-2.15) and sarcoidosis (aHR, 1.59; 95% CI, 1.00-2.52).

However, risk for systemic lupus erythematosus was low among patients with COVID-19 (aHR, 0.47; 95% CI, 0.36-0.61).

The severity of COVID-19 was associated with an increased risk for alopecia totalis, psoriasis, vitiligo, vasculitis, Crohn disease, ulcerative colitis, rheumatoid arthritis, adult-onset Still disease, Sjögren syndrome, ankylosing spondylitis, and sarcoidosis.

Study findings may be limited in their applicability to younger populations and other ethnicities, as it primarily involved adult patients of Korean descent.

Study authors concluded, “Although the risks of developing each disease following COVID-19 varied, there was a clear tendency toward increased risk overall, especially in those who experienced a severe case of COVID-19. This suggests the existence of a common pathway, which may involve excessive cytokine storm leading to prolonged autoimmune responses that trigger specific underlying pathophysiology of each disease.”

This article originally appeared on Rheumatology Advisor