Autoinflammatory and autoimmune conditions at the crossroad of COVID-19

Yhojan Rodríguez, Lucia Novelli, Manuel Rojas, Maria De Santis, Yeny Acosta-Ampudia, Diana M. Monsalve, Carolina Ramírez-Santana, Antonio Costanzo, William M. Ridgway, Aftab A. Ansari, M. Eric Gershwin, Carlo Selmi, Juan Manuel Anaya

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Coronavirus disease 2019 (COVID-19) has been categorized as evolving in overlapping phases. First, there is a viral phase that may well be asymptomatic or mild in the majority, perhaps 80% of patients. The pathophysiological mechanisms resulting in minimal disease in this initial phase are not well known. In the remaining 20% of cases, the disease may become severe and/or critical. In most patients of this latter group, there is a phase characterized by the hyperresponsiveness of the immune system. A third phase corresponds to a state of hypercoagulability. Finally, in the fourth stage organ injury and failure occur. Appearance of autoinflammatory/autoimmune phenomena in patients with COVID-19 calls attention for the development of new strategies for the management of life-threatening conditions in critically ill patients. Antiphospholipid syndrome, autoimmune cytopenia, Guillain-Barré syndrome and Kawasaki disease have each been reported in patients with COVID-19. Here we present a scoping review of the relevant immunological findings in COVID-19 as well as the current reports about autoinflammatory/autoimmune conditions associated with the disease. These observations have crucial therapeutic implications since immunomodulatory drugs are at present the most likely best candidates for COVID-19 therapy. Clinicians should be aware of these conditions in patients with COVID-19, and these observations should be considered in the current development of vaccines.

Original languageEnglish (US)
Article number102506
JournalJournal of Autoimmunity
StatePublished - Nov 24 2020

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology


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