Autoimmune rheumatic conditions tied to higher long COVID risk
A retrospective study compared patients with autoimmune rheumatic diseases to matched controls and found long COVID in 2.8% versus 1.5%. The autoimmune condition was associated with a 56% higher risk after adjustment. More severe acute COVID-19, lung disease, obesity, and certain immunosuppressive treatments were also linked to greater long COVID risk in this group.
Researchers drew on a U.S. national clinical cohort and paired each patient with an autoimmune rheumatic disease to a similar control without one, using propensity matching. Among 187,106 matched patients, long COVID appeared in 2.8% of the autoimmune group and 1.5% of controls.
After adjustment, the autoimmune condition corresponded to a 56% higher long COVID risk. Within that group, more severe initial COVID-19, lung disease, obesity, and treatment with rituximab or glucocorticoids tracked with elevated risk; Sjögren syndrome also showed a higher risk. The findings appeared in Arthritis & Rheumatology.
For people with autoimmune rheumatic diseases, these findings could heighten awareness of long COVID and may prompt closer follow-up after infection, especially for those with obesity, lung disease, severe acute illness, or certain immunosuppressive treatments. Clinicians may use the results to consider individualized monitoring, while health systems could face added demand for post-COVID care. Because the study is retrospective, it cannot prove causation, so patients should discuss risks with their care teams rather than change treatment on their own.