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As the world reels against the malicious Covid-19, there is still so much that is not known about the disease. Preliminary studies have shown that severe Covid-19 can trick the immune system into producing so-called autoantibodies that attack the healthy tissues in the body and lead to several complications. Dr Suma Balan Consultant Paediatrician and Paediatric Rheumatologist – Department of Rheumatology & Clinical Immunology, Amrita Hospital Kochi say, “one of the significant features of coronavirus is that it is able to activate the immune system in a number of different ways. In some cases, it can trigger autoimmune conditions autoimmune cytopenias, Guillain Barre Syndrome, etc.”
What Leads To Autoimmune Disorders?
Dr Ashutosh Shukla, Senior Director – Internal Medicine & Medical Advisor – Max Hospital, Gurgaon, explains “COVID-19 triggers an autoimmune response and as a result, oxidative phosphorylation in the cells is increased and there is a higher release of free radicals.”
Free radicals are reactive oxygen species that are associated with this low-grade chronic inflammation and there is decreased efficiency of small ordinary infect mitochondria in the cells. “All of this causes a late immune metabolic inflammatory change, and which results in unresolved immune cell defect. So, since it involves the entire body, there are various organs that are involved. It is not only the lungs where there is long-standing damage to the tiny air spaces in the alveoli, resulting in scar tissue but also in the heart, which leads to lasting damage to the heart muscles, and this may increase the risk of heart failure later. Since it is a systematic response across the body, it also impacts the brain and because of this chronic inflammation, chances of autoimmune diseases,” he added.
Are New Variants Leading To An Increased Risk Of Autoimmune Diseases Among People Infected With The Virus?
According to Dr Sanjay Saxena, Medical Director, Max Hospital, Vaishali, “We already know that viruses can abnormally stimulate the immune system of the persons, which can lead to the wrong identification of various organs of one’s own body as a foreign particle and they start damaging the individual’s organs, leading to complications and high mortality risk. Now, we have a more infectious and deadly virus, Covid-19 and its variants like Delta can trigger an autoimmune response very early in the course of the disease.”
He further explained that after 5-7 days of getting infected with the coronavirus, the virus triggers a high autoimmune response in the body called a cytokine storm, which is an inflammatory response of the body against the infection. So, there is a change in the identification of the antigen and there is a mimicry of antigens, which means that some individuals become susceptible to autoimmune disorders. This means that antibodies that are formed target one’s own body and depending on the type of antibody, it can damage various organs and different parts of the body.
“COVID-19 Delta variant has led to an increase in the autoimmune changes in the body. From the neurological perspective, one of the very first symptoms that have been described as a part of Covid-19 is loss of taste and smell. So, this happens most likely due to an immune-mediated inflammation of the nerve, which carries the temptation of smell to the brain. So, this is the first sign which means that this is an autoimmune-related disease which leads to loss of taste and smell,” Dr Saxena elaborated.
Autoimmune Conditions More Common In Covid Delta Patients
Further explaining the effect of Delta and Delta plus variant on Covid-induced autoimmune diseases, Dr Saxena said that there was much more extensive involvement of the nerves in patients infected with the Delta variant. “Even Alpha variant, which was identified last year, led to immune-mediated complications but Delta variant was very rampant and led to more autoimmune-related secondary diseases like Guillain Barre Syndrome (a disease that damages the nerve sheet that covers all the nerves of the body).”
“So, many patients who were infected with the Delta variant developed Guillain barre syndrome and had a difficult time initially but many of them who did not have pulmonary or lung or cardiac complications responded well to the standard treatment of this syndrome.” The Medical Director of Max Hospital told us that some patients experienced the direct invasion of the virus into the brain, which led to encephalitis, which poses a high risk to life. But some patients developed delayed encephalitis, which could be autoimmune triggered encephalitis or encephalopathy, but they also have high mortality risk.”
Severe Covid-19 can also trigger thrombogenicity, which is an autoimmune response when the blood becomes very thick and there is an increased tendency to form clots, leading to vasculitis symptoms like affecting the lungs, ARDS, renal complications, etc.
Even Vaccines Can Trigger An Autoimmune Response In People
While there is still no cure for COVID-19, vaccines were made available to control the surge of the virus. However, people did experience some side effects of the vaccines post-administration, but that should not be a cause of fear regarding the vaccines. “Vaccines tend to trigger an autoimmune response and that is how they work. But in some cases, it can lead to some immune-mediated complications and some patients might develop facial paralysis, Guillain barre syndrome, and encephalitis but the cases are rare. This happens in the case of an abnormal immune response from the patients who have received a vaccine.”
“Covid-19 related autoimmune diseases are much more extensive, much more lethal and if they are identified early then the treatment in the form of aggressive immunomodulatory therapy, including intravenous globulin, plasma exchange and steroid can help the patients. Some of the patients did respond to these treatments, other patients had a very aggressive response to the Delta variant, which led to high mortality risk in these patients,” he added.
So, not only does it lead to direct invasion of the virus but it also leads to damage to local narcosis. The immune triggered complications are responsible for high mortality rates among people infected with the Covid-19 Delta variant.
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