Risk of Autoimmune Diseases Triples After COVID-19 Infection, 6 Tips to Reduce Susceptibility to Long COVID

The risk of immune diseases triples after infection with COVID-19. Keep an eye on six health indicators to reduce the chance of getting long COVID. Starocean/Shutterstock

The long-term chronic effects of COVID-19 cannot be ignored. Studies have shown that six months after being diagnosed with COVID-19, the risk of developing an autoimmune disease is three times that of an uninfected person. Virology experts say following six health guidelines can help reduce the incidence of long COVID.

A research team analyzed data from TriNetX, a global electronic medical records database, which included more than 3.81 million participants (880,000 confirmed and more than 2.9 million undiagnosed) who underwent PCR screening from 2020 to 2021. After tracking them for 180 days, the risk of autoimmune diseases in those diagnosed was three times that of those not infected.

Compared with the undiagnosed control group, the probability of suffering from various immune system diseases in confirmed patients was as follows:

• 2.98 times for rheumatoid arthritis
• 3.21 times for ankylosing spondylitis
• 2.99 times for systemic lupus erythematosus
• 1.96 times for vasculitis and dermatopolymyositis
• 2.58 times for systemic sclerosis
• 2.62 times for Sjögren’s syndrome
• 3.14 times for mixed connective tissue disease
• 2.32 times for Behçet’s disease
• 2.90 times for polymyalgia rheumatica
• 2.91 times for psoriasis
• 1.78 times for inflammatory bowel disease
• 2.68 times for celiac disease
• 2.68 times for Type 1 diabetes
• 1.20 times for mortality rate

The research results were published in EClinicalMedicine, a sister journal of The Lancet Discovery Science.

Dr. Wei Zhengzong, the paper’s author and vice director of the Affiliated Hospital of Chung Shan Medical University in Taiwan, said that a confirmed case of COVID-19 will activate the immune response, resulting in a cytokine storm. The structure of the virus antigen may also be similar to one’s self-antigen, causing a cross-reaction that attacks self-tissue cells and organs, inducing autoimmune diseases.

Dr. Wei said that if the diagnosed person suffers long-term joint pain, skin rash, unexplained hair loss, fever, mouth ulcers, etc., after recovery, he or she is advised to seek medical attention immediately.

Pathogenesis of Long COVID

An article published in Nature Immunology in 2022 explored the pathogenesis of long COVID, including the persistent chronic inflammatory state the disease induces, autoimmune system abnormalities, and the virus’ long-term existence in the body.

Dr. Dong Yuhong, a European expert in virology and infectious diseases, explained on the NTDTV program “Health 1+1“ that although the virus may no longer be detected in the respiratory tract, it does not mean it is no longer in the body. It may lurk in relatively hidden tissues like the brain and gastrointestinal tract.

A study published in Nature showed that about four months after the infection of 14 asymptomatic infected persons, half of them had the COVID-19 virus’ nucleic acid in their intestines, indicating that the virus can remain in the body for a long time.

In addition, some inflammatory factors will still be present in the patient’s body. One of these is interleukin-6, related to many diseases, including mental anxiety and depression.

Moreover, COVID-19 patients’ inflammatory cells will continue to be activated, causing dysfunction of monocytes, T cells, and dendritic cells. This activation is closely related to immune system dysfunction, leading to pulmonary fibrosis and chronic inflammation of the neurological system.

6 Health Guidelines to Reduce Risk of Long COVID

Dr. Dong emphasized that long COVID is primarily a result of insufficient immunity, leading to the loss of one’s normal ability to clear the virus. An unhealthy lifestyle will further aggravate long COVID. The more severe the inflammatory state, the harder it is for the body to eliminate the virus.

She cited a study published in JAMA Internal Medicine that indicates adhering to the following six guidelines can reduce your risk of developing long COVID. If you follow at least five of these six, you will reduce the risk of developing long COVID by 49 percent:

1. Maintain a healthy body mass index (BMI): This is your weight in kilograms divided by the square of height (in meters). A healthy BMI is between 18.5 and 24.9.
2. Don’t smoke: This includes e-cigarettes.
3. Exercise regularly: Get at least 150 minutes of moderate-intensity physical activity weekly.
4. Drink alcohol in moderation: Consume only 5 to 15 grams (0.2 to 0.5 ounce) of alcohol daily. Dr. Dong pointed out that drinking a small amount of alcohol may stimulate blood circulation but that everyone’s ability to metabolize alcohol differs.
5. Eat a high-quality diet: Dr. Dong said a high-quality diet should be based on natural, unrefined whole foods. The less processed the food, the more nutrients available.
6. Get enough sleep: An average adult needs at least seven hours of sleep every day. However, more sleep is not always better. Studies have found that people who sleep less than seven hours have a 12 percent higher risk of death, and those who sleep more than nine hours have a 30 percent higher risk of death. More sleep does not equate to quality sleep.

Dr. Dong added that a healthy lifestyle can prevent other common chronic diseases, such as hyperlipidemia, high blood pressure, and hyperglycemia.