This article gives us an idea of how COVID viruses are producing chronic difficulties as a result of auto-immune and musculoskeletal symptoms associated with long-term COVID infections.

Autoimmune disorders and virus correlation

Coronavirus disease 2019 (COVID-19) continues to spread after the pandemic began. Few autoimmune disorders include:

• SLE
• Rheumatoid arthritis
• Sjögren's syndrome
• Systemic vasculitis
• Celiac disease
• Multiple sclerosis all have a history of viral infections interfering with the development of these autoimmune disorders.

Some prominent viruses that may provoke autoimmune illnesses include:

• The hepatitis C virus
• The hepatitis B virus
• The Chikungunya virus
• Parvovirus B19
• Herpes

1. The processes by which viruses cause autoimmunity remain poorly understood. Historically, cross-reactive T-cell recognition-referred to as molecular mimicry, and bystander T-cell activation- were the primary methods by which infection may result in a T-cell-mediated autoimmune response. However, alternative ideas, such as virus-induced immune system decoys, merit consideration for their potential to generate autoimmunity.
2. According to doctors, individuals who recovered from COVID had signs of rheumatoid arthritis, including fever, dry eyes, and mouth. While the majority of patients were in the age range of 18-50 years, AIIMS began seeing these patients after the pandemic's second and third covid waves.
3. However, clinicians have a tough time determining the rate at which such occurrences have grown post-COVID. "It is impossible to estimate the rise in incidences at this point since we have seen the majority of referral cases and other people came to us directly with symptoms. We would have to do a community survey to determine the magnitude of the post-COVID rise in auto-immune cases," an AIIMS specialist stated during a news briefing on post-COVID systemic inflammatory autoimmune illnesses, their prevention, and therapy.
4. Auto-immune diseases are those in which our immune system, which typically does not destroy cells, protein tissues, or organs of the body, exceeds a threshold of tolerance and then fails to recognise and attack the body. That is why the term "auto-immunity" is used.
5. Researchers from Mexico stated in a paper published in the journal Cells that there was emerging evidence that COVID-19 may result in immunological dysregulation and the development of autoimmune diseases.

"This immune dysregulation has a variety of consequences, from the creation of autoantibodies to the beginning of rheumatic autoimmune illness," the report said.

Autoimmune illnesses: What causes them?

1. The oxidative phosphorylation in cells and the generation of free radicals are both elevated when COVID-19 initiates an autoimmune response.
2. Low-grade chronic inflammation is connected with the production of reactive oxygen species known as free radicals, which reduce the efficiency of mitochondria in cells.
3. A late immunological metabolic inflammatory alteration is brought on by all of this, and this leads to an unsolved malfunction in immune cells. As a result, many organs are affected since it affects the whole body.
4. Alveoli aren't only damaged in the lungs; scar tissue may also build up in the heart, leading to an increased risk of heart failure down the road. As a systemic reaction, it also affects the brain, increasing the risk of developing autoimmune illnesses as a result of chronic inflammation.

Are new variants increasing the risk of autoimmune diseases among virus survivors?

1. Viruses may inappropriately activate a person's immune system, causing them to mistakenly identify different organs in their own body as foreign particles and begin causing damage to the individual's organs, resulting in problems and high mortality risk. Now that we have a highly infectious and lethal virus, COVID-19 and its variations such as Delta and Omicron, we may initiate an autoimmune response very soon in the disease's progression.
2. After 5-7 days of infection, the coronavirus induces a strong autoimmune reaction in the body termed a cytokine storm, which is the body's inflammatory response to the infection. Thus, the antigen's identity is altered and antigens are mimicked, making certain persons prone to autoimmune illnesses. This implies that antibodies are created against one's own body, and depending on the kind of antibody, they might cause harm to a variety of organs and body components.
3. The COVID-19 Delta variation has been associated with an increase in autoimmune reactions in the body. From a neurological standpoint, one of the very first symptoms associated with COVID -19 is loss of taste and smell. Thus, this occurs most likely as a result of immune-mediated inflammation of the nerve that transmits the smell to the brain. Thus, this is the first indication that this is an inflammatory illness resulting in a loss of taste and smell.

The autoimmune response may be triggered by vaccines as well

1. COVID-19 is currently incurable, although vaccinations are available to slow its spread. Although some persons did report adverse reactions to the immunisations after administration, this should not be a reason for concern about the vaccines. Vaccines function by inducing an autoimmune reaction. However, in rare circumstances, it might result in immune-mediated problems, such as facial paralysis, Guillain-Barré syndrome, and encephalitis. This occurs when individuals who have received a vaccination have an aberrant immunological response.
2. COVID-19-related autoimmune disorders are significantly more severe and deadly, but if detected early, vigorous immunomodulatory therapy, including intravenous globulin, plasma exchange, and steroid therapy, may benefit patients. While some patients responded to these therapies, others had a more strong reaction to the Delta variation, resulting in significant mortality risk.
3. As a result, it not only results in a direct viral invasion but also in harm to local narcosis. Immune-mediated problems are a major cause of death in patients infected with the COVID -19 Delta form.

Disclaimer- The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of M3 India.

The author is a practising super specialist from New Delhi.