diCarlo Selmi
Many cases have been described of people who developed chronic inflammatory or autoimmune diseases, such as arthritis or vasculitis, after contracting the viral infection
I read that there may be a link between Covid and an increased risk of developing rheumatological diseases: is this true? What is this association based on?
Carlo Selmi, head of Rheumatology and Clinical Immunology, Humanitas Institute, Milan responds (GO TO THE FORUM)
Since the early stages of the Sars-CoV-2 pandemic, a direct link between Covid and chronic inflammatory and autoimmune diseases has been hypothesized. This came after the identification of common mechanisms between Covid and rheumatoid arthritis or the so-called cytokine release syndrome (also known as cytokine storm), which is observed as a consequence of both Covid and some rheumatological diseases. There are at least three observations that have strengthened this hypothesis.
Drugs used in rheumatology
First, many cases have been described of people who developed chronic inflammatory or autoimmune diseases, such as arthritis or vasculitis, after contracting the viral infection. Second, immunological mechanisms associated with Covid severity are also important in rheumatological diseases, as in the case of interleukin 6 (IL-6) in rheumatoid arthritis. Third: Covid was successfully treated using drugs that have been in use for a long time also in rheumatology, such as tocilizumab or glucocorticoids.
The study conducted in Hong Kong
Based on these links, it was hypothesized that having had Covid could increase the risk of developing a rheumatological disease and that vaccination against Sars-CoV-2 could reduce it. A study, conducted in Hong Kong between April 2020 and November 2022, compared the risk of developing autoimmune diseases (including many rheumatological diseases) in over one million subjects who had Covid and three million people who did not contract the infection .
The vaccine reduces the risk
The comparison of these two large populations showed that those who had had Covid showed a significantly higher risk of developing spondyloarthritis (+32%), rheumatoid arthritis (+29%), vasculitis (+46%), compared to people who had not had the infection. Completing two doses of the Sars-CoV-2 vaccine instead reduced the risk of developing other rheumatological diseases, such as anti-phospholipid antibody syndrome and systemic lupus erythematosus.
The role of inflammation
Mechanisms that could explain this increased risk of rheumatological diseases include the role of inflammation observed during Covid as a trigger of autoimmunity, a mechanism common to many rheumatological diseases.
April 27, 2024
© ALL RIGHTS RESERVED