IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. TsokosCOVID-19 and autoimmune diseasesLiu, Yua; Sawalha, Amr H.b; Lu, Qianjina,c Author Information aDepartment of Dermatology, Second Xiangya Hospital, Central South University, Hunan Key Laboratory of Medical Epigenetics, Changsha, Hunan, PR China bDepartments of Pediatrics, Medicine, and Immunology, and Lupus Center of Excellence, University of Pittsburgh, Pittsburgh, Pennsylvania, USA cInstitute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China Correspondence to Qianjin Lu, MD, PhD, #139 Renmin Middle Rd, Changsha, Hunan 410011, P.R. China. Tel: +86 731 85295860; fax: +86 731 85533525; e-mail: [email protected], Amr H. Sawalha, MD, 7123 Rangos Research Center, 4401 Penn Avenue, Pittsburgh, PA 15224, USA. Tel: +1 412 692 8140; fax: +1 412 412 692 5054; e-mail: [email protected] Current Opinion in Rheumatology: March 2021 - Volume 33 - Issue 2 - p 155-162 doi: 10.1097/BOR.0000000000000776 Buy Metrics Abstract 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--Barré 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. Summary 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. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.