Risk of Autoimmune Rheumatic Diseases following COVID-19: A Systematic Review and Meta-Analysis.

IF 1.3 Q4 RHEUMATOLOGY

Current rheumatology reviews Pub Date : 2025-10-02 DOI:10.2174/0115733971382167250921213314

Aris P Agouridis, Anastasios Makris, Danae Ellina, Georgios Vougiouklakis, Konstantinos Alexakis, Georgios Toulkeridis, Despo Ierodiakonou, Constantinos Tsioutis, Nikolaos Spernovasilis

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引用次数: 0

Abstract

Introduction: Multiple cases of autoimmune rheumatic diseases following COVID-19 have been reported in the literature. This study aims to systematically determine whether COVID-19 affects the incidence of autoimmune rheumatic diseases.

Methods: We searched MEDLINE (PubMed), Global Index Medicus, and Cochrane Library da-tabases up to March 30, 2024, for studies evaluating the incidence of systemic autoimmune dis-eases following SARS-CoV-2 infection in adult populations.

Results: Eight cohort studies with 5,537,742 COVID-19 and 18,433,129 non-COVID-19 patients were included in our pooled analysis. The risk of developing mixed connective tissue disease and Behçet's disease in COVID-19 patients was increased by 168% (RR: 2.68, 95% CI (1.14 to 6.34), I²=94%) and 101% (RR: 2.01, 95% CI (1.4 to 2.87), I²=6%), respectively, compared to uninfected subjects. A 45% increase in the risk of both rheumatoid arthritis (RR: 1.45, 95% CI (1.02 to 2.06), I²=99%) and psoriasis (RR: 1.45, 95% CI (1.10 to 1.92), I²=98%) after SARS-CoV-2 infection was noted. The risk of dermatopolymyositis was 40% higher (RR: 1.40, 95% CI (1.10 to 1.79), I²=68%) in the COVID-19 group. Non-significant increases in risk were observed in the pooled analysis for ankylosing spondylitis (RR: 1.39, 95% CI (0.94 to 2.05), I²=93%), systemic lupus er-ythematosus (RR: 1.21, 95% CI (0.70 to 2.07), I²=98%), systemic sclerosis (RR: 1.23, 95% CI (0.73 to 2.04), I²=89%), Sjögren's syndrome (RR: 1.28, 95% CI (0.91 to 1.80), I²=95%), and pol-ymyalgia rheumatica (RR: 1.45, 95% CI (0.94 to 2.25), I²=94%).

Discussion: Since the onset of COVID-19, several cases of new-onset autoimmune rheumatic diseases following SARS-CoV-2 infection have been reported. To the best of our knowledge, this is the first systematic review and meta-analysis assessing the impact of COVID-19 on the risk of developing autoimmune rheumatic diseases. Overall, COVID-19 increases the risk of autoim-mune rheumatic diseases, especially during the first year after infection.

Conclusion: COVID-19 is associated with an increased risk of several autoimmune rheumatic diseases, including mixed connective tissue disease, Behçet's disease, rheumatoid arthritis, psori-asis, and dermatopolymyositis. However, our results must be interpreted with caution due to high inter-study heterogeneity.

Registration: PROSPERO CRD42023480593.

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COVID-19后自身免疫性风湿病的风险：系统回顾和荟萃分析

文献报道了多例新冠肺炎后的自身免疫性风湿病。本研究旨在系统地确定COVID-19是否影响自身免疫性风湿性疾病的发病率。方法：检索截至2024年3月30日的MEDLINE （PubMed）、Global Index Medicus和Cochrane Library数据库，以评估成年人群感染SARS-CoV-2后系统性自身免疫性疾病的发生率。结果：8项队列研究纳入了5,537,742例COVID-19患者和18,433,129例非COVID-19患者。与未感染的受试者相比，COVID-19患者发生混合性结缔组织病和behet病的风险分别增加了168% （RR: 2.68, 95% CI (1.14 ~ 6.34), I²=94%）和101% （RR: 2.01, 95% CI (1.4 ~ 2.87), I²=6%）。注意到SARS-CoV-2感染后，类风湿关节炎（RR: 1.45, 95% CI (1.02 ~ 2.06), I²=99%）和牛皮癣（RR: 1.45, 95% CI (1.10 ~ 1.92), I²=98%）的风险增加45%。在COVID-19组中，皮肤多肌炎的风险高出40% （RR: 1.40, 95% CI (1.10 ~ 1.79), I²=68%）。在合并分析中，强直性脊柱炎（RR: 1.39, 95% CI (0.94 ~ 2.05), I²=93%）、系统性红斑狼疮（RR: 1.21, 95% CI (0.70 ~ 2.07), I²=98%）、系统性硬化症（RR: 1.23, 95% CI (0.73 ~ 2.04), I²=89%）、Sjögren综合征（RR: 1.28, 95% CI (0.91 ~ 1.80), I²=95%）和风湿性多肌痛（RR: 1.45, 95% CI (0.94 ~ 2.25), I²=94%）的风险无显著增加。讨论：自COVID-19发病以来，已报道了几例SARS-CoV-2感染后新发自身免疫性风湿性疾病。据我们所知，这是第一个评估COVID-19对自身免疫性风湿性疾病风险影响的系统综述和荟萃分析。总体而言，COVID-19增加了自身免疫性风湿病的风险，特别是在感染后的第一年。结论：COVID-19与多种自身免疫性风湿病的风险增加有关，包括混合性结缔组织病、behet病、类风湿性关节炎、银屑病和皮肤多肌炎。然而，由于研究间的高度异质性，我们的结果必须谨慎解释。注册号：PROSPERO CRD42023480593。

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来源期刊

Current rheumatology reviews RHEUMATOLOGY-

CiteScore

2.30

自引率

0.00%

发文量

期刊介绍： Current Rheumatology Reviews publishes frontier reviews on all the latest advances on rheumatology and its related areas e.g. pharmacology, pathogenesis, epidemiology, clinical care, and therapy. The journal"s aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all researchers and clinicians in rheumatology.