Autoimmune Disease is Associated with Heightened Long COVID Risk but Prior Immunization is Protective, 2026, Malakooti et al

[forestglip]

Autoimmune Disease is Associated with Heightened Long COVID Risk but Prior Immunization is Protective

Spoiler: Authors

Malakooti, Shahdi K.; Abboud, Marc; Murphy, Jennifer E.; Singer, Nora G.; McComsey, Grace A.

Objectives
Patients with autoimmune disease (AD) may be predisposed to Long COVID, yet the impact of primary autoantibody-associated AD and prior immunization remains unclear.

Methods
TriNetX, a global electronic health database, identified adults with confirmed SARS-CoV-2 infection between January 1, 2020 and September 21, 2023 and at least one follow-up visit >90 days later. Long COVID was defined as persistent or new symptoms ≥90 days after infection.

Patients with and without pre-existing AD were propensity-score-matched on demographics and comorbidities. Logistic regression assessed odds of Long COVID, with additional sensitivity analyses performed.

Results
Among 2,472,196 patients with SARS-CoV-2, 289,206 had AD (+AD). After matching, baseline characteristics were similar.

+AD patients had higher odds of all Long COVID symptoms compared with -AD patients. The highest odds were observed for disturbance to smell/taste (OR:1.99;95%CI:1.88-2.11), hair loss (OR:1.96;95%CI:1.89-2.04), abnormal movements/tremors (OR:1.93;95%CI:1.88-1.98), and body aches (OR:1.85;95%CI:1.81-1.89).

Unvaccinated +AD patients had higher odds of all symptoms compared with matched unvaccinated -AD. Within +AD, primary autoantibody-associated AD demonstrated higher odds of most symptoms.

Conclusion
Pre-existing AD increases the risk of Long COVID, with the highest risk in primary autoantibody-associated AD. Prior vaccination mitigates the risk of most Long COVID symptoms in +AD patients, with heightened protection observed in primary autoantibody-associated AD.

Web | DOI | PDF | International Journal of Infectious Diseases | Open Access

 

[V.R.T.]

Pre-existing AD increases the risk of Long COVID, with the highest risk in primary autoantibody-associated AD

Does this tell us anything interesting?

 

[Jonathan Edwards]

Does this tell us anything interesting?

Without going through a whole lot of potentially confounding reasons for association I suspect not much. It would be interesting if some autoimmune disease predisposed and others protected perhaps.

I am not sure what 'primary autoantibody-associated disease' means.

 

[Jonathan Edwards]

I cannot find any information about the 'autoimmune diseases' they included. They seem to be in a supplementary table not available. The lack of any up front information makes me think the results are pretty uninterpretable. As far as I am concerned all autoimmune diseases have autoantibodies s their subclassification suggests that they are including non-autoimmune inflammatory diseases (maybe like psoriasis).

It may just mean that people who are already ill are more likely to need to see a doctor after Covid.

 

[forestglip]

I cannot find any information about the 'autoimmune diseases' they included. They seem to be in a supplementary table not available.

It looks like it's linked at the bottom (direct link to doc file). Here is the list of autoimmune diseases from Supplementary Table S1 and the sentences that reference the table:

AD was defined as a documented diagnosis prior to the date of the first documented COVID-19 infection. [...] See Supplementary Tables S1 and S2 for ICD-10 codes and laboratory tests used to define AD and Long COVID symptoms.

Adult-onset Still's disease
Ankylosing spondylitis
Autoimmune hepatitis
Autoimmune thyroiditis
Behcet’s Disease
Celiac disease
Cerebral arteritis, not elsewhere classified
Crohn's disease
Dermatopolymyositis
Hypersensitivity angiitis
Microscopic polyangiitis
Multifocal fibrosclerosis
Other Overlap syndromes
Other reactive arthropathies
Other rheumatoid arthritis
Polyarteritis nodosa and related conditions
Polymyalgia rheumatica
Psoriasis
Reactive arthropathy, unspecified
Relapsing panniculitis
Rheumatoid arthritis with rheumatoid factor
Sarcoidosis
Sjögren syndrome
Systematic sclerosis (scleroderma)
Systemic involvement of connective tissue, unspecified
Systemic lupus erythematosus (SLE)
Thyrotoxicosis with diffuse goiter
Type I diabetes mellitus
Ulcerative colitis
Vasculitis limited to skin, not elsewhere classified
Wegener’s granulomatosis

 

[Jonathan Edwards]

Here is the list of autoimmune diseases from Supplementary Table S1 and the sentences that reference the table:

So a wastebasket of every uncle Tom Cobley disease you can think of.