Unravelling the Risk of Autoimmune Diseases After SARS-CoV-2 Infection: A Meta-analysis

Background: Emerging evidence suggests a potential link between coronavirus disease 2019 (COVID-19) and the development of autoimmune diseases. This study aims to assess the pooled risk of this association. Methods: A Literature search was conducted across three databases. Full-text, English-language cohorts between 2019 and 2023 were included. Standard meta-analysis methods were employed using the random-effects model and heterogeneity was assessed using the I 2 statistic. Results: Data analysed across five studies revealed the following hazard ratios, confidence intervals (CIs) and I 2 heterogenicity; systemic lupus erythematosus (SLE) 1.12 (CI [0.53-2.35, I 2 0.99]); RA 1.35 (CI [0.86–2.10, I 2 0.99]); psoriasis 1.39 (CI [0.98–1.97, I 2 0.99]); Sjögren 1.24 (CI [0.79–1.96, I 2 0.97]); PMR 1.33 (CI [0.80–2.22, I 2 0.96]); spondyloarthropathies 1.41 (CI [0.90–2.20, I 2 0.96]); anti-neutrophil cytoplasmic antibody (ANCA) vasculitis 1.93 (CI [1.46–2.55, I 2 0.66]); cutaneous vasculitis 1.6 (CI [0.97–2.69, I 2 0.86]); mixed connective tissue disease (MCTD) 2.04 (CI [0.90–4.92, I 2 0.96]); sarcoidosis 1.50 (CI [0.85–2.64, I 2 0.95]); inflammatory myopathies 0.91 (CI [0.65–1.28, I 2 0.23]); SS 1.15 (CI [0.61–2.18, I 2 0.94]); adult-onset Stills disease 1.00 (CI [0.63–1.59, I 2 0]); IBD 1.34 (CI [0.94–1.90, I 2 0.98]); celiac disease 1.57 (CI [0.90–2.73, I 2 0.99]); type 1 diabetes mellitus (T1DM) 1.66 (CI [1.08–2.56, I 2 0.99]). Conclusion: This meta-analysis identifies an increased risk of ANCA-associated vasculitis and type 1 diabetes mellitus (T1DM) following COVID-19 infection. While some conditions, such as cutaneous vasculitis and MCTD, show trends toward increased risk, additional studies are necessary to confirm these associations. Further research is crucial to understand the underlying mechanisms and long-term implications of COVID-19-induced autoimmunity.