{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:23:20Z","timestamp":1760235800806,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T00:00:00Z","timestamp":1632787200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicines"],"abstract":"<jats:p>Coronavirus disease 2019 (COVID-19) can progress to severe pneumonia with respiratory failure and is aggravated by the deregulation of the immune system causing an excessive inflammation including the cytokine storm. Since 2019, several studies regarding the interplay between autoimmune diseases and COVID-19 infections is increasing all over the world. In addition, thanks to new scientific findings, we actually know better why certain conditions are considered a higher risk in both situations. There are instances when having an autoimmune disease increases susceptibility to COVID-19 complications, such as when autoantibodies capable of neutralizing type I IFN are present, and other situations in which having COVID-19 infection precedes the appearance of various autoimmune and autoinflammatory diseases, including multisystem inflammatory syndrome in children (MIS-C), Guillain-Barr\u00e9 syndrome, and Autoimmune haemolytic anaemia (AIHA), thus, adding to the growing mystery surrounding the SARS-CoV-2 virus and raising questions about the nature of its link with autoimmune and autoinflammatory sequelae. Herein, we discuss the role of host and virus genetics and some possible immunological mechanisms that might lead to the disease aggravation.<\/jats:p>","DOI":"10.3390\/medicines8100055","type":"journal-article","created":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T21:38:09Z","timestamp":1632865089000},"page":"55","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Autoimmune Disorders &amp; COVID-19"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3013-3173","authenticated-orcid":false,"given":"Leonardo","family":"Freire-de-Lima","sequence":"first","affiliation":[{"name":"Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aline Miranda","family":"Scovino","sequence":"additional","affiliation":[{"name":"Instituto de Microbiologia Paulo de G\u00f3es, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil"},{"name":"Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro 21040-360, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camilla Cristie","family":"Barreto Menezes","sequence":"additional","affiliation":[{"name":"Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro 21040-360, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8239-6843","authenticated-orcid":false,"given":"Leonardo","family":"Marques da Fonseca","sequence":"additional","affiliation":[{"name":"Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jhenifer","family":"Santos dos Reis","sequence":"additional","affiliation":[{"name":"Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcos Andr\u00e9","family":"Rodrigues da Costa Santos","sequence":"additional","affiliation":[{"name":"Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelli","family":"Monteiro da Costa","sequence":"additional","affiliation":[{"name":"Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Antonio do Nascimento Santos","sequence":"additional","affiliation":[{"name":"Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4148-3657","authenticated-orcid":false,"given":"Celio Geraldo","family":"Freire-de-Lima","sequence":"additional","affiliation":[{"name":"Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre","family":"Morrot","sequence":"additional","affiliation":[{"name":"Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro 21040-360, Brazil"},{"name":"Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21044-020, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1038\/ni.3731","article-title":"The multiple pathways to autoimmunity","volume":"18","author":"Theofilopoulos","year":"2017","journal-title":"Nat. Immunol."},{"key":"ref_2","unstructured":"Kono, D., and Theofilopoulos, A.N. (2017). Kelley and Firestein\u2019s Textbook of Rheumatology, Elsevier."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1038\/nm.4142","article-title":"The microbiome in early life: Implications for health outcomes","volume":"22","author":"Tamburini","year":"2016","journal-title":"Nat. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1038\/nrg.2015.33","article-title":"Autoimmune diseases\u2014Connecting risk alleles with molecular traits of the immune system","volume":"17","author":"Rich","year":"2016","journal-title":"Nat. Rev. Genet."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1128\/CMR.19.1.80-94.2006","article-title":"Molecular mimicry, bystander activation, or viral persistence: Infections and autoimmune disease","volume":"19","author":"Fujinami","year":"2006","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s12016-007-8013-6","article-title":"Hepatitis B virus (HBV) and autoimmune disease","volume":"34","author":"Maya","year":"2008","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.jaut.2008.08.007","article-title":"Lupus-like autoantibody development in rabbits and mice after immunization with EBNA-1 fragments","volume":"31","author":"Poole","year":"2008","journal-title":"J. Autoimmun."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1080\/1040841X.2019.1614904","article-title":"The role of viral infections in the development of autoimmune diseases","volume":"45","author":"Hussein","year":"2019","journal-title":"Crit. Rev. Microbiol."},{"key":"ref_9","unstructured":"(2021, September 20). WHO Coronavirus (COVID-19) Dashboard. Available online: https:\/\/covid19.who.int\/."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1001\/jama.2020.2648","article-title":"Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases from the Chinese Center for Disease Control and Prevention","volume":"323","author":"Wu","year":"2020","journal-title":"JAMA"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1093\/cid\/ciaa248","article-title":"Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China","volume":"71","author":"Qin","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1002\/jmv.25685","article-title":"Coronavirus infections and immune responses","volume":"92","author":"Li","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Arcanjo, A., Pinto, K.G., Logullo, J., Leite, P.E.C., Menezes, C.C.B., Freire-de-Lima, L., Diniz-Lima, I., Decote-Ricardo, D., Rodrigues-da-Silva, R.N., and Freire-de-Lima, C.G. (2021). Critically ill COVID-19 patients exhibit hyperactive cytokine responses associated with effector exhausted senescent T cells in acute infection. J. Infect. Dis.","DOI":"10.1093\/infdis\/jiab425"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1002\/iid3.404","article-title":"Age-related differences in the immune response could contribute to determine the spectrum of severity of COVID-19","volume":"9","author":"Costagliola","year":"2021","journal-title":"Immun. Inflamm. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1126\/science.abd4570","article-title":"Inborn errors of type I IFN immunity in patients with life-threatening COVID-19","volume":"370","author":"Zhang","year":"2020","journal-title":"Science"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Bastard, P., Rosen, L.B., Zhang, Q., Michailidis, E., Hoffmann, H.H., Zhang, Y., Dorgham, K., Philippot, Q., Rosain, J., and B\u00e9ziat, V. (2020). Autoantibodies against type I IFNs in patients with life-threatening COVID-19. Science, 370.","DOI":"10.1126\/science.abd4585"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1093\/infdis\/150.5.707","article-title":"Characteristics of autoantibodies to human interferon in a patient with varicella-zoster disease","volume":"150","author":"Pozzetto","year":"1984","journal-title":"J. Infect. Dis."},{"key":"ref_18","first-page":"283","article-title":"Diverse Functional Autoantibodies in Patients with COVID-19","volume":"595","author":"Wang","year":"2020","journal-title":"medRxiv"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.jocn.2020.04.062","article-title":"Guillain Barre syndrome associated with COVID-19 infection: A case report","volume":"76","author":"Sedaghat","year":"2020","journal-title":"J. Clin. Neurosci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2574","DOI":"10.1056\/NEJMc2009191","article-title":"Guillain-Barr\u00e9 Syndrome Associated with SARS-CoV-2","volume":"382","author":"Toscano","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1212\/NXI.0000000000000781","article-title":"Guillain-Barr\u00e9 syndrome: The first documented COVID-19-triggered autoimmune neurologic disease: More to come with myositis in the offing","volume":"7","author":"Dalakas","year":"2020","journal-title":"Neurol. Neuroimmunol. Neuroinflamm."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e38","DOI":"10.1056\/NEJMc2007575","article-title":"Coagulopathy and Antiphospholipid Antibodies in Patients with Covid-19","volume":"382","author":"Zhang","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1126\/scitranslmed.abd3876","article-title":"Prothrombotic autoantibodies in serum from patients hospitalized with COVID-19","volume":"12","author":"Zuo","year":"2020","journal-title":"Sci. Transl. Med."},{"key":"ref_24","first-page":"1","article-title":"Autoimmunity to the Lung Protective Phospholipid-Binding Protein Annexin A2 Predicts Mortality Among Hospitalized COVID-19 Patients","volume":"1","author":"Zuniga","year":"2021","journal-title":"medRxiv"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1097\/00006454-200211000-00002","article-title":"Commentary: Translation of Dr. Tomisaku Kawasaki\u2019s original report of fifty patients in 1967","volume":"21","author":"Burns","year":"2002","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1038\/s41577-020-0367-5","article-title":"Understanding SARS-CoV-2-related multisystem inflammatory syndrome in children","volume":"20","author":"Rowley","year":"2020","journal-title":"Nat. Rev. Immunol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1186\/s12969-021-00559-5","article-title":"Severe COVID-19 in pediatric age: An update on the role of the anti-rheumatic agents","volume":"19","author":"Costagliola","year":"2021","journal-title":"Pediatr. Rheumatol. Online J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"102597","DOI":"10.1016\/j.autrev.2020.102597","article-title":"Covid-19 and autoimmunity","volume":"19","author":"Ehrenfeld","year":"2020","journal-title":"Autoimmun. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e43","DOI":"10.1056\/NEJMc2010472","article-title":"Immune Thrombocytopenic Purpura in a Patient with Covid-19","volume":"382","author":"Zulfiqar","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/bjh.16794","article-title":"Autoimmune haemolytic anaemia associated with COVID-19 infection","volume":"190","author":"Lazarian","year":"2020","journal-title":"Br. J. 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