PMID- 36786873
OWN - NLM
STAT- MEDLINE
DCOM- 20230517
LR  - 20230517
IS  - 1437-160X (Electronic)
IS  - 0172-8172 (Print)
IS  - 0172-8172 (Linking)
VI  - 43
IP  - 7
DP  - 2023 Jul
TI  - A systematic review of the incidence, management and prognosis of new-onset 
      autoimmune connective tissue diseases after COVID-19.
PG  - 1221-1243
LID - 10.1007/s00296-023-05283-9 [doi]
AB  - A literature review on new-onset autoimmune connective tissue diseases (ACTDs) 
      following COVID-19 is lacking. We evaluated potential associations between 
      COVID-19 and the development of new-onset ACTDs. The "population" was adults with 
      disease terms for ACTDs, including systemic lupus erythematosus (SLE), Sjogren's 
      syndrome, systemic sclerosis (SSc), idiopathic inflammatory myositis (IIM), 
      anti-synthetase syndrome, mixed CTD and undifferentiated CTD, and "intervention" 
      as COVID-19 and related terms. Databases were searched for English-language 
      articles published until September 2022. We identified 2236 articles with 28 
      ultimately included. Of the 28 included patients, 64.3% were female, with a mean 
      age was 51.1 years. The USA reported the most cases (9/28). ACTD diagnoses 
      comprised: 11 (39.3%) IIM (including four dermatomyositis); 7 (25%) SLE; four 
      (14.3%) anti-synthetase syndrome; four (14.3%) SSc; two (7.1%) other ACTD (one 
      lupus/MCTD overlap). Of eight, four (14.3%) patients (including that with 
      lupus/MCTD) had lupus nephritis. The average time from COVID-19 to ACTD diagnosis 
      was 23.7 days. A third of patients were admitted to critical care, one for 
      treatment of haemophagocytic lymphohistiocytosis in SLE (14 sessions of 
      plasmapheresis, rituximab and intravenous corticosteroids) and nine due to 
      COVID-19. 80% of patients went into remission of ACTD following treatment, while 
      three (10%) patients died-one due to macrophage activation syndrome with 
      anti-synthetase syndrome and two from unreported causes. Our results suggest a 
      potential association between COVID-19 and new-onset ACTDs, notably in young 
      females, reflecting more comprehensive CTD epidemiology. The most common 
      diagnosis in our cohort was IIM. The aetiology and mechanisms by which ACTDs 
      emerge following COVID-19 remain unknown and require further research.
CI  - (c) 2023. The Author(s).
FAU - Kouranloo, Koushan
AU  - Kouranloo K
AUID- ORCID: 0000-0002-6276-137X
AD  - School of Medicine, University of Liverpool, Ashon St., Liverpool, L69 3GE, UK. 
      k.kouranloo@doctors.net.uk.
AD  - Royal Liverpool University NHS Foundation Trust, Prescot St., Liverpool, L7 8XP, 
      UK. k.kouranloo@doctors.net.uk.
FAU - Dey, Mrinalini
AU  - Dey M
AD  - Department of Rheumatology, Queen Elizabeth Hospital, Stadium Rd., London, SE18 
      4QH, UK.
AD  - Institute of Life Health Sciences, University of Liverpool, Liverpool, L7 8TX, 
      UK.
FAU - Elwell, Helen
AU  - Elwell H
AD  - BMA Library, BMA House, Tavistock Square, British Medical Association, London, 
      WC1H 9JP, UK.
FAU - Nune, Arvind
AU  - Nune A
AD  - Department of Rheumatology, Southport and Ormskirk NHS Foundation Trust, 
      Southport, PR8 6PN, UK.
LA  - eng
PT  - Systematic Review
DEP - 20230214
PL  - Germany
TA  - Rheumatol Int
JT  - Rheumatology international
JID - 8206885
SB  - IM
MH  - Adult
MH  - Humans
MH  - Female
MH  - Middle Aged
MH  - Male
MH  - *Mixed Connective Tissue Disease
MH  - Incidence
MH  - *COVID-19/epidemiology/therapy
MH  - *Connective Tissue Diseases/diagnosis/epidemiology/therapy
MH  - *Autoimmune Diseases
MH  - *Lupus Erythematosus, Systemic/diagnosis
MH  - *Scleroderma, Systemic/diagnosis/epidemiology/therapy
MH  - Prognosis
MH  - *Lupus Nephritis
MH  - *Myositis
PMC - PMC9927056
OTO - NOTNLM
OT  - Autoimmune connective tissue diseases
OT  - COVID-19
OT  - Pandemic
OT  - Rheumatic disease
OT  - SARS-CoV-2
COIS- The authors (KK, MD, HE, AN) declare no conflicts of interest.
EDAT- 2023/02/15 06:00
MHDA- 2023/05/17 06:42
PMCR- 2023/02/14
CRDT- 2023/02/14 11:15
PHST- 2023/01/06 00:00 [received]
PHST- 2023/01/30 00:00 [accepted]
PHST- 2023/05/17 06:42 [medline]
PHST- 2023/02/15 06:00 [pubmed]
PHST- 2023/02/14 11:15 [entrez]
PHST- 2023/02/14 00:00 [pmc-release]
AID - 10.1007/s00296-023-05283-9 [pii]
AID - 5283 [pii]
AID - 10.1007/s00296-023-05283-9 [doi]
PST - ppublish
SO  - Rheumatol Int. 2023 Jul;43(7):1221-1243. doi: 10.1007/s00296-023-05283-9. Epub 
      2023 Feb 14.