Abstract
While first and foremost considered a respiratory infection, COVID-19 can result in complications affecting multiple organs. Immune responses in COVID-19 can both protect against the disease as well as drive it. Insights into these responses, and specifically the targets being recognised by the immune system, are of vital importance in understanding the side effects of COVID-19 and associated pathologies. The body’s adaptive immunity recognises and responds against specific targets (antigens) expressed by foreign pathogens, but not usually to target self-antigens. However, if the immune system becomes dysfunctional, adaptive immune cells can react to self-antigens, which can result in autoimmune disease. Viral infections are well reported to be associated with, or exacerbate, autoimmune diseases such as multiple sclerosis (MS) and systemic lupus erythematosus (SLE). In COVID-19 patients, both new onset MS and SLE, as well as the occurrence of other autoimmune-like pathologies, have been reported. Additionally, the presence of autoantibodies, both with and without known associations to autoimmune diseases, have been found. Herein we describe the mechanisms of virally induced autoimmunity and summarise some of the emerging reports on the autoimmune-like diseases and autoreactivity that is reported to be associated with SARS-CoV-2 infection.
Highlights
Since the emergence of the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) in December 2019, as of 16 August 2021, there have been more than 207.1 million confirmed cases of COVID-19 and more than 4.3 million associated deaths [1]
It is suggested that vaccine induced prothrombotic immune thrombocytopenia (VIPIT) is similar to autoimmune-heparin induced thrombocytopenia [60], a disease where anti-platelet factor 4 (PF4) autoantibodies are implicated in aetiology [61]
Autoimmune Haemolytic Anaemia and Cold Agglutinin Syndrome. Both autoimmune haemolytic anaemia (AIHA), a rare blood condition characterised by the presence of autoantibodies to red blood cells, and cold agglutinin syndrome, a form of AIHA characterised by anti-red blood cell agglutination at low temperatures, have been reported in COVID-19 patients [64,65,66,67]
Summary
Since the emergence of the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) in December 2019, as of 16 August 2021, there have been more than 207.1 million confirmed cases of COVID-19 and more than 4.3 million associated deaths [1]. COVID-19 is commonly characterised with a sore throat, dry cough, fever and loss of taste or smell [2,3,4] It is a multi-organ disease resulting in complications (such as acute injuries or abnormal tests) in the heart [5], gastrointestinal tract [6] and nervous system [7,8,9], as examples. By studying and measuring T cell responses, insights into the role of T cells for the resolution of primary infection, as well as the establishment of long-term immunological memory able to react effectively to subsequent infections, can be gained This is key for the development of both therapeutic and vaccine strategies
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