{"doi":"10.1172/jci154886","title":"The intersection of COVID-19 and autoimmunity","abstract":"Acute COVID-19, caused by SARS-CoV-2, is characterized by diverse clinical presentations, ranging from asymptomatic infection to fatal respiratory failure, and often associated with varied longer-term sequelae. Over the past 18 months, it has become apparent that inappropriate immune responses contribute to the pathogenesis of severe COVID-19. Researchers working at the intersection of COVID-19 and autoimmunity recently gathered at an American Autoimmune Related Diseases Association Noel R. Rose Colloquium to address the current state of knowledge regarding two important questions: Does established autoimmunity predispose to severe COVID-19? And, at the same time, can SARS-CoV-2 infection trigger de novo autoimmunity? Indeed, work to date has demonstrated that 10% to 15% of patients with critical COVID-19 pneumonia exhibit autoantibodies against type I interferons, suggesting that preexisting autoimmunity underlies severe disease in some patients. Other studies have identified functional autoantibodies following infection with SARS-CoV-2, such as those that promote thrombosis or antagonize cytokine signaling. These autoantibodies may arise from a predominantly extrafollicular B cell response that is more prone to generating autoantibody-secreting B cells. This Review highlights the current understanding, evolving concepts, and unanswered questions provided by this unique opportunity to determine mechanisms by which a viral infection can be exacerbated by, and even trigger, autoimmunity. The potential role of autoimmunity in post-acute sequelae of COVID-19 is also discussed.","journal":"Journal of Clinical Investigation","year":2021,"id":146478,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":218,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9589,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":598394,"name":"Roberto Caricchio","orcid":"0000-0002-1379-1118","position":1,"is_corresponding":false},{"id":57373,"name":"Jean-Laurent Casanova","orcid":"0000-0002-7782-4169","position":2,"is_corresponding":false},{"id":553722,"name":"Alexis J. Combes","orcid":"0000-0002-9110-6542","position":3,"is_corresponding":false},{"id":285336,"name":"Betty Diamond","orcid":"0000-0002-3250-3804","position":4,"is_corresponding":false},{"id":624378,"name":"Sharon E. Fox","orcid":null,"position":5,"is_corresponding":false},{"id":226887,"name":"David A. Hanauer","orcid":"0000-0001-6931-3791","position":6,"is_corresponding":false},{"id":226234,"name":"Judith A. James","orcid":"0000-0002-9574-7355","position":7,"is_corresponding":false},{"id":105700,"name":"Yogendra Kanthi","orcid":"0000-0002-5660-5194","position":8,"is_corresponding":false},{"id":624379,"name":"Virginia Ladd","orcid":null,"position":9,"is_corresponding":false},{"id":89271,"name":"Puja Mehta","orcid":"0000-0001-9459-9306","position":10,"is_corresponding":false},{"id":17340,"name":"Aaron M. Ring","orcid":"0000-0003-3699-2446","position":11,"is_corresponding":false},{"id":624380,"name":"Ignacio Sanz","orcid":null,"position":12,"is_corresponding":false},{"id":622862,"name":"Carlo Selmi","orcid":"0000-0002-0323-0376","position":13,"is_corresponding":false},{"id":25028,"name":"Russell P. Tracy","orcid":"0000-0002-0080-2420","position":14,"is_corresponding":false},{"id":22091,"name":"Paul J. Utz","orcid":"0000-0003-1181-1565","position":15,"is_corresponding":false},{"id":624381,"name":"Catriona A. Wagner","orcid":null,"position":16,"is_corresponding":false},{"id":382948,"name":"Julia Y. Wang","orcid":"0000-0002-9458-5825","position":17,"is_corresponding":false},{"id":624382,"name":"William J. McCune","orcid":null,"position":18,"is_corresponding":false},{"id":105701,"name":"Jason S. Knight","orcid":"0000-0003-0995-9771","position":0,"is_corresponding":true}],"reference_count":120,"raw_metadata":null,"created_at":"2026-07-18T23:42:24.567796Z","pmid":"34710063","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}