Development of Autoimmune Diseases After SARS-CoV-2 Infection
Because SARS-CoV-2 infection can break immune tolerance and trigger autoimmune responses, it is also likely to induce clinical autoimmunity. Indeed, many reports have confirmed the development of autoimmune diseases after SARS-CoV-2 infection. Cold agglutinin syndrome (CAS) and autoimmune haemolytic anaemia have been reported as a complication of COVID-19.[55,58,59] Meanwhile, Guillain--Barré syndrome (GBS) is also emerging as an autoimmune disease that may occur in COVID-19 patients. In most cases of COVID-19 associated GBS SARS-CoV-2 antibodies cannot be detected in the cerebrospinal fluid (CSF); however, Gigli et al. recently reported a case of GBS with a positive test for the SARS-CoV-2 antibodies in the CSF.[61,62] The mechanisms of how SARS-CoV-2 triggers GBS are debated. However, immune cross reaction between epitopes and host antigens may be a possible explanation. Recently, a case of systemic lupus erythematosus has also been reported to be triggered by SARS-CoV-2. It is possible that additional autoimmune diseases induced by SARS-CoV-2 will be reported in the future.
Curr Opin Rheumatol. 2021;33(2):155-162. © 2021 Lippincott Williams & Wilkins