Severe COVID-19 infections and being unvaccinated were associated with higher long-term risks of autoimmune and autoinflammatory disorders, according to a recent study.

In the large cohort study conducted in South Korea, published in JAMA Dermatology, investigators found an increased long-term risk of autoimmune and autoinflammatory connective tissue disorders following COVID-19 infections. The study included 6.9 million participants, with 3.1 million of the participants diagnosed with COVID-19 infections and 3.8 million controls, all observed for a minimum of 180 days. The analysis revealed statistically significant increased risks for conditions such as alopecia areata (adjusted hazard ratio [HR] = 1.11), alopecia totalis (adjusted HR = 1.24), vitiligo (adjusted HR = 1.11), and rheumatoid arthritis (adjusted HR = 1.09) in the COVID-19 cohort compared with controls.

The investigators also found that participants with severe COVID-19 infections, those requiring intensive care, and unvaccinated participants exhibited higher risks of developing autoimmune disorders. Subgroup analyses indicated that younger participants and male patients were more likely to develop certain autoimmune diseases, whereas older adults were more susceptible to others. Specific conditions such as Behçet disease (adjusted HR = 1.45), Crohn's disease (adjusted HR = 1.35), and ulcerative colitis (adjusted HR = 1.15) were also more prevalent among those with COVID-19 infections.

Vaccinated participants had a reduced risk of developing many autoimmune disorders, suggesting that long-term monitoring may be particularly beneficial among those with severe infections or who are unvaccinated.

Full disclosures can be found in the published study.