COVID-19 is a trigger of autoimmune rheumatic diseases: a hypothesis tested over time.

We discuss the paper recently published in Rheumatology Internationa. This article reflects on the prevalence of autoimmune rheumatic diseases (ARD) during the COVID-19 pandemic (2020-2023) and compares the same with the pre-pandemic period (2016-2019). We assume that SARS-CoV-2 triggers ARD. This study concerns the 10 million population of Greece, and this work convincingly confirms our hypothesis. Besides, four large cohort studies have demonstrated an increased incidence of autoimmune diseases after surviving COVID-19. Compared to the prepandemic period, all ARD increased, and RA growth in the index study reached a level of more than 20% during the pandemic. A similar trend was observed in our report covering four Central Asian republics, namely Kazakhstan, Kyrgyzstan, Uzbekistan, and Tajikistan. The alarming growth of ARDs due to the consequences of the pandemic can still be predicted for the coming years. Healthcare professionals worldwide should be aware of this hypothesis to plan their COVID-19, long COVID, and ARD diagnostic and therapeutic strategies. We agree with the authors of the index article that more resources and research studies are warranted to optimize the diagnosis and treatment of ARDs in this challenging time.