Immunoinflammatory evidence of rheumatoid arthritis caused by COVID-19

Abstract Purpose The relationship between coronavirus disease 2019 (COVID-19) and rheumatoid arthritis (RA) remains uncertain. We aimed to assess the association between COVID-19 and RA through immune inflammation. Methods First, we conducted a meta-analysis on the risk of COVID-19 infection, hospit...

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Main Authors: Zhiqiang Shao, Dan Xia, Liang Zhou, Zonghan Xu, Jiaqian Wang
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Biological Research
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Online Access:https://doi.org/10.1186/s40659-025-00620-7
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author Zhiqiang Shao
Dan Xia
Liang Zhou
Zonghan Xu
Jiaqian Wang
author_facet Zhiqiang Shao
Dan Xia
Liang Zhou
Zonghan Xu
Jiaqian Wang
author_sort Zhiqiang Shao
collection DOAJ
description Abstract Purpose The relationship between coronavirus disease 2019 (COVID-19) and rheumatoid arthritis (RA) remains uncertain. We aimed to assess the association between COVID-19 and RA through immune inflammation. Methods First, we conducted a meta-analysis on the risk of COVID-19 infection, hospitalization rate, and mortality rate for patients with RA. Then, Mendelian randomization (MR) was used to evaluate the causal relationship between COVID-19 and RA, and further analyzed the cytokines and immune cells in COVID-19 and RA. Finally, we obtained microarray datasets of COVID-19, RA patients, and normal controls from the GEO database. And performed functional, pathway enrichment, and immune cell infiltration analysis on differentially expressed genes between each group. Results The meta-analysis results suggested that the hospitalization rate and mortality rate of RA patients infected with COVID-19 were higher than those of the control population. MR analysis showed a positive correlation between COVID-19 infection and RA. We also found that interleukin 13 was associated with RA and COVID-19 infection. CD27 on IgD + CD24 + B cells and CD3 on CD39 + CD8 + T cells are common immune cell phenotypes in two diseases. In addition, COVID-19 function is enriched in immune responses mediated by leukocytes and neutrophils, while RA is significantly enriched in the proliferation of T and B lymphocytes. The results of immune cell infiltration showed that both diseases had more neutrophils and fewer CD8 T cells. Conclusion There are many similarities between COVID-19 and RA in immune inflammatory responses such as cytokines and immune cells. COVID-19 may lead to the development of RA through immune inflammation.
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spelling doaj-art-3a8d7dc77a1c46acb94576ed5b96d0db2025-08-20T03:20:59ZengBMCBiological Research0717-62872025-06-0158111310.1186/s40659-025-00620-7Immunoinflammatory evidence of rheumatoid arthritis caused by COVID-19Zhiqiang Shao0Dan Xia1Liang Zhou2Zonghan Xu3Jiaqian Wang4Department of Orthopedic, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School of Nanjing Medical UniversityDepartment of Respiratory, Affiliated Wuxi Fifth Hospital of Jiangnan UniversityDepartment of Orthopedic, Huai’an Hospital Affiliated to Yangzhou University, The Fifth People’s Hospital of Huai’anDepartment of Orthopedic, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School of Nanjing Medical UniversityDepartment of Orthopedic, Zhongshan Hospital, Fudan UniversityAbstract Purpose The relationship between coronavirus disease 2019 (COVID-19) and rheumatoid arthritis (RA) remains uncertain. We aimed to assess the association between COVID-19 and RA through immune inflammation. Methods First, we conducted a meta-analysis on the risk of COVID-19 infection, hospitalization rate, and mortality rate for patients with RA. Then, Mendelian randomization (MR) was used to evaluate the causal relationship between COVID-19 and RA, and further analyzed the cytokines and immune cells in COVID-19 and RA. Finally, we obtained microarray datasets of COVID-19, RA patients, and normal controls from the GEO database. And performed functional, pathway enrichment, and immune cell infiltration analysis on differentially expressed genes between each group. Results The meta-analysis results suggested that the hospitalization rate and mortality rate of RA patients infected with COVID-19 were higher than those of the control population. MR analysis showed a positive correlation between COVID-19 infection and RA. We also found that interleukin 13 was associated with RA and COVID-19 infection. CD27 on IgD + CD24 + B cells and CD3 on CD39 + CD8 + T cells are common immune cell phenotypes in two diseases. In addition, COVID-19 function is enriched in immune responses mediated by leukocytes and neutrophils, while RA is significantly enriched in the proliferation of T and B lymphocytes. The results of immune cell infiltration showed that both diseases had more neutrophils and fewer CD8 T cells. Conclusion There are many similarities between COVID-19 and RA in immune inflammatory responses such as cytokines and immune cells. COVID-19 may lead to the development of RA through immune inflammation.https://doi.org/10.1186/s40659-025-00620-7COVID-19Rheumatoid arthritisImmune cellsMendelian randomizationMeta-analysis
spellingShingle Zhiqiang Shao
Dan Xia
Liang Zhou
Zonghan Xu
Jiaqian Wang
Immunoinflammatory evidence of rheumatoid arthritis caused by COVID-19
Biological Research
COVID-19
Rheumatoid arthritis
Immune cells
Mendelian randomization
Meta-analysis
title Immunoinflammatory evidence of rheumatoid arthritis caused by COVID-19
title_full Immunoinflammatory evidence of rheumatoid arthritis caused by COVID-19
title_fullStr Immunoinflammatory evidence of rheumatoid arthritis caused by COVID-19
title_full_unstemmed Immunoinflammatory evidence of rheumatoid arthritis caused by COVID-19
title_short Immunoinflammatory evidence of rheumatoid arthritis caused by COVID-19
title_sort immunoinflammatory evidence of rheumatoid arthritis caused by covid 19
topic COVID-19
Rheumatoid arthritis
Immune cells
Mendelian randomization
Meta-analysis
url https://doi.org/10.1186/s40659-025-00620-7
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AT danxia immunoinflammatoryevidenceofrheumatoidarthritiscausedbycovid19
AT liangzhou immunoinflammatoryevidenceofrheumatoidarthritiscausedbycovid19
AT zonghanxu immunoinflammatoryevidenceofrheumatoidarthritiscausedbycovid19
AT jiaqianwang immunoinflammatoryevidenceofrheumatoidarthritiscausedbycovid19