COVID-19 and autoimmune diseases.
COVID-19 and autoimmune diseases.
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DOI：
10.1097/bor.0000000000000776
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发表时间：
2021-03-01
影响因子：
5.1
通讯作者：
Lu Q
中科院分区：
文献类型：
--
作者：
Liu Y;Sawalha AH;Lu Q
本研究的目的是评价SARS-CoV-2感染与自身免疫的关系。2019冠状病毒病（COVID-19）是由严重急性呼吸综合征（SARS）相关冠状病毒2（SARS-CoV-2）引起的传染病。尽管大多数感染者无症状，但有一部分COVID-19患者发展为严重疾病，伴有多器官损伤。有证据表明，一些用于治疗自身免疫性风湿病的药物可能对严重COVID-19感染的患者有治疗作用，这引起了人们对COVID-19与自身免疫性疾病之间关系的关注。COVID-19与自身免疫性疾病在临床表现、免疫反应和致病机制方面具有相似性。强大的免疫反应参与了这两种疾病的发病机制。作为自身免疫性疾病标志的自身抗体也可以在COVID-19患者中检测到。此外，据报道，一些患者在COVID-19感染后会患上自身免疫性疾病，如格林-巴利综合征或系统性红斑狼疮。据推测，SARS-CoV-2可以通过与宿主细胞的交叉反应来干扰自身耐受并触发自身免疫反应。COVID-19在自身免疫性疾病患者中的感染风险和预后仍然存在争议，但强烈建议患者坚持药物治疗方案以预防自身免疫性疾病发作。我们对COVID-19与自身免疫性疾病之间的关联进行了综述，重点关注免疫反应的相似性、SARS-CoV-2的交叉反应性、COVID-19患者自身免疫性疾病的发展以及已有自身免疫性疾病的患者感染COVID-19的风险。
The aim of this study was to evaluate the relationship between infection with SARS-CoV-2 and autoimmunity. Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome (SARS) associated coronavirus 2 (SARS-CoV-2). Although most of the infected individuals are asymptomatic, a proportion of patients with COVID-19 develop severe disease with multiple organ injuries. Evidence suggests that some medications used to treat autoimmune rheumatologic diseases might have therapeutic effect in patients with severe COVID-19 infections, drawing attention to the relationship between COVID-19 and autoimmune diseases. COVID-19 shares similarities with autoimmune diseases in clinical manifestations, immune responses and pathogenic mechanisms. Robust immune reactions participate in the pathogenesis of both disease conditions. Autoantibodies as a hallmark of autoimmune diseases can also be detected in COVID-19 patients. Moreover, some patients have been reported to develop autoimmune diseases, such as Guillain--Barré syndrome or systemic lupus erythematosus, after COVID-19 infection. It is speculated that SARS-CoV-2 can disturb self-tolerance and trigger autoimmune responses through cross-reactivity with host cells. The infection risk and prognosis of COVID-19 in patients with autoimmune diseases remains controversial, but patient adherence to medication regimens to prevent autoimmune disease flares is strongly recommended. We present a review of the association between COVID-19 and autoimmune diseases, focusing on similarities in immune responses, cross-reactivity of SARS-CoV-2, the development of autoimmune diseases in COVID-19 patients and the risk of COVID-19 infection in patients with preexisting autoimmune conditions.