Abstract

JAROLIN, Dora Montiel et al. Autoimmune Manifestations in Patients with COVID-19. Rev. parag. reumatol. [online]. 2021, vol.7, n.2, pp.34-40. ISSN 2413-4341.  https://doi.org/10.18004/rpr/2021.07.02.34.

Introduction: Several autoimmune manifestations concurrent with or following COVID-19 infection have been reported. The purpose of this work is to present a case series of COVID-19 patients with autoimmune or autoinflammatory features.

Methods: Case series of adult patients with a history of COVID-19 and autoinmune or autoinflammatory manifestations presenting during or after the acute infection, admitted to the “Hospital Nacional” of Paraguay, between September 2020 and August 2021.

Results: We present ten patients with a history of COVID-19 infection and autoimmune manifestations, with an average of 20 days between the onset of COVID-19 symptoms and autoimmune manifestations (range: 8-30 days). 40% of the patients had underlying pathologies, such as arterial hypertension, obesity, chronic kidney disease, diabetes, smoking, and illicit drug use (cocaine). No patient had a history of rheumatic disease. The most frequent autoimmune complication was Guillain-Barré Syndrome (GBS) (40%), followed by vasculitis. SARS-CoV-2 PCR in nasopharyngeal or oropharyngeal swabs was positive in 80% of cases. Antibodies to SARS-CoV-2 were detectable in 4 cases. Cytopenias (severe anemia and thrombocytopenia) were found in patients with Systemic Lupus Erythematosus (SLE), Thrombotic Thrombocytopenic Purpura (TTP), and Immune Thrombocytopenic Purpura (ITP). Two patients had autoantibodies: one patient with SLE (ANA) and one patient with Granulomatosis with Polyangiitis (c-ANCA). Eight patients had favorable outcomes with immunosuppressive treatment (systemic corticosteroids, IVIG, cyclophosphamide, and Mycophenolate mofetil). The remaining two patients died.

Conclusion: GBS, cytopenias, and vasculitis were the most frequent autoinmune manifestations associated with SARS-CoV-2 infection. Most patients had a favorable outcome with immunosuppressive treatment.

Keywords : autoimmune; autoinflammatory; COVID-19; SARS-COV-2.

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