New onset autoimmune issues post COVID and post vaccine.

The last few years have made it even more critical for us to be aware of developments in healthcare. And right now, we are seeing a tsunami of autoimmune issues after a COVID infection and post-COVID vaccine. Given that virtually all diseases are inflammatory in origin, including multiple sclerosis and other neurological conditions, it’s especially worrisome to consider the implications.

These presentations could be a NEW disease or worsening of the patient's underlying autoimmune disease; I believe this is related to molecular mimicry of spike protein as it impacts so  many different tissues and organs and about which we have previously written at length.
 
One recent study showed 44% of patients had a positive antinuclear antibody (ANA) following a bout with COVID. That’s a substantial increase for this test, which is most often administered to look for conditions such as systemic lupus erythematosus (SLE or lupus), rheumatoid arthritis, and others.
 
Another paper adds to the volumes of data to date that show post COVID (and post vaccine) patients are at high risk for the development of autoimmune disease and or worsening of their underlying disease due to lingering spike protein. This is because spike protein viral fragments share incredible molecular mimicry with the body and brain. The cohort study looked at nearly 642,000 patients with COVID and found a 42.63% higher likelihood of acquiring autoimmunity for patients who had suffered from COVID-19. This estimate was similar for common autoimmune diseases, such as Hashimoto thyroiditis, rheumatoid arthritis, or Sjögren syndrome. The highest incident rate ration (IRR) was observed for autoimmune disease of the vasculitis group. 

Relative to the results post vaccine, in this case, “Acute Pericarditis with High Anti-Nuclear Antibody Titers Following BNT162b2 mRNA COVID-19 Vaccination,” a 23-year-old patient presenting with atypical chest pain had a positive ANA result with a titer of 1:640. The initial workup, including cardiac enzyme tests, cardiac MRI, and EKG, was negative for significant findings. Fortunately, she was seen by an excellent team of physicians who had a strong clinical suspicion of pericarditis or inflammation of the heart tissues. She was started on successful treatment and a follow up EKG did indeed show a pericardial effusion.
 
A recent news release presented information that on routine screenings over 50% of people had evidence of myocarditis, which can be associated with an increased risk of sudden cardiac death (SCD).
 
So, what can we do to address these concerns?
 
First, we should never ignore chest pain or any cardiac symptoms, especially in our young adults and youth who have been vaccinated. An emergency room visit is NOT enough to identify potential serious issues – patients should receive a FULL cardiac workup.
 
I advise practitioners conducting autoimmune labs to also check the antiphospholipid antibody for we are more often seeing this test, which is related to blood clotting disorders, come back as positive. Patients’ autoimmune labs should be rechecked yearly if not every six months.
 
In summary 
 
The long-term implications for emerging autoimmune issues after repeated COVID vaccinations and COVID infections are unknown. Whether we see more instances of pericarditis, as well as new onset MS, vasculitis, autoimmune neuropathies, thyroid disease, hepatitis, and potentially many other illnesses is something that remains to be seen and about which we must stay vigilant going forward. And we must take the time to really listen to patient input and any complaints in order to truly identify the causes behind their symptoms. 
 
In hope and healing,
Dr. Suzanne Gazda
 
Other related reading from our blog library:
 
https://www.suzannegazdamd.com/blog---long-covid/the-immune-system-is-on-high-alert
 
https://www.suzannegazdamd.com/blog---long-covid/a-protocol-for-treatment-starts-with-tamping-down-inflammation
 
For more reading about inflammation and COVID-related topics, please see our full series at:
https://www.suzannegazdamd.com/blog---long-covid
 
References:
 
Martin, E. Persistent positive ANA tests 1 year after COVID-19 may predict long COVID symptoms. Healio. January 3, 2023.
https://www.healio.com/news/rheumatology/20230103/persistent-positive-ana-tests-1-year-after-covid19-may-predict-long-covid-symptoms
 
Tesch, F. et al. Incident autoimmune diseases in association with a SARS-CoV-2 infection: A matched cohort study. medRxiv. January 25, 2023.
https://www.medrxiv.org/content/10.1101/2023.01.25.23285014v1
 
Chen YS, Wu YW, Chiang CH, Lin HH. Acute Pericarditis with High Anti-Nuclear Antibody Titers Following BNT162b2 mRNA COVID-19 Vaccination. Acta Cardiol Sin. 2022;38(6):784-787. doi:10.6515/ACS.202211_38(6).20220522A
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9692212/
 
News release
https://menafn.com/1105647135/Cardiac-Testing-At-Washington-Event-Found-53-Myocarditis-Rate
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