Risk factors for new-onset autoimmune diseases in long Covid patients: a real-world cohort

8th International Congress on Controversies in Rheumatology and Autoimmunity (CORA 2025)
Venise 6-8 mars 2025

Abstract 573
Risk factors for new-onset autoimmune diseases in long Covid patients: a real-world cohort

Type: Late Breaking Abstract Submission
Topic: AS13. COVID and autoimmunity
Authors: Marc Jamoulle, Johan Van Weyenbergh, Belgium
Background and Aims
Long COVID is estimated to affect 400 million people worldwide, with a strong autoimmune component suspected in its pathogenesis. In a general practice-based prospective cohort, we aimed to identify risk factors for new-onset autoimmune disease among Long COVID patients.
Methods
Clinical and demographic data were available for 111 patients with Long COVID, diagnosed according to WHO criteria. ICPC codes were used to identify pre-existing and incident autoimmune diseases (standardized national electronic health records). Human Phenotype Ontology (HPO) was used for classification. COOP-charts were used to quantify patient-reported quality of life (QoL). Risk factors were identified by multivariable logistic regression, prediction was tested with ROC curve analysis.
Results
Out of 111 Long COVID patients, 16 had pre-existing autoimmune disease (rheumatoid arthritis, type I diabetes, psoriasis, IBD and others). During >220 person-years of follow-up, 22 incident cases of autoimmune disease were observed, of which 12 (55%) were IBD, and 4 (18%) anti-phospholipid syndrome. Patients with new-onset autoimmunity were more frequently female, unvaccinated and had experienced less acute COVID 19 episodes. Among patient-reported QoL data at baseline, COOP-change score was significantly higher for subsequent incident cases (p=0.044). Female sex (OR 4.42 [1.12-22.13]) , vaccination status (OR 0.092 [0.0078- 0.60]) and COOP-change (OR 2.42 [1.15-5.81]) were independent risk factors for new-onset autoimmune disease in multivariable logistic regression. Together, these risk factors significantly predicted new-onset autoimmune disease (AUROC 0.79 [0.67-0.92], p=0.0002).
Conclusions
In a real-world prospective cohort, female sex and worse COOP-change QoL score are independent negative predictors of new-onset autoimmune disease in Long COVID, while SARS-CoV-2 vaccination is protective.