Meta-Analysis Links COVID-19 to 11 Autoimmune Diseases

In a recent study, authors conducted a meta-analysis of six observational studies to gather evidence of confirmed SARS-CoV-2 infection increasing the risk of developing immune-mediated diseases (IMIDs). While reviews on case reports have been previously published, a gap exists for analytic studies. Previous reviews also include IMID diagnoses less than 30 days post-infection, without considering the potential bias in symptom development that may occur regardless of infection.

Confirmed SARS-CoV-2 cases were compared against individuals without a prior history of infection, and diagnoses made within the first 30 days post-infection were excluded to avoid capturing early post-infection effects.

Findings across all six studies showed a higher risk of developing at least 11 IMIDs in the confirmed COVID-19 group compared to the non-exposed group. These include: Sjögren disease, Behçet’s disease, spondyloarthritis, Systemic sclerosis, Systemic lupus erythematosus, psoriasis, rheumatoid arthritis, polymyalgia rheumatica, type 1 diabetes (in adults), vasculitis, and inflammatory bowel disease.

The association between confirmed infection and IMIDs ranged from a relative risk of ~2.31 (systemic sclerosis) to ~3.71 (Behcet’s disease). Polymyalgia rheumatica, psoriasis, Rheumatoid arthritis, Sjogren’s syndrome, and SLE were also reported to have significantly elevated or elevated levels of risk. On the flip side, Guillain-Barré Syndrome and type 1 diabetes in the pediatric population showed no clear increased risk in the data if accounted for 30+ days after initial infection.

Authors emphasized that autoimmune conditions are being increasingly recognized under the umbrella of “long Covid,” calling for increased monitoring of IMIDs and other autoimmune diseases post-COVID-19 infection, especially past the 30-day mark. They also note that observational data cannot prove a causative effect between SARS-CoV-2 infection and the development of autoimmune disease, especially since the time between acute infection and diagnosis ranged among the six studies.

Citation

Gil, A. M., et al. (2025). Risk of new onset of immune-mediated diseases after SARS-CoV-2 infection: A systematic review and meta-analysis. Seminars in arthritis and rheumatism, 74, 152805. https://doi.org/10.1016/j.semarthrit.2025.152805