SARS-CoV-2 triggers Autoimmunity: implications for the pathogenesis of Post-Acute COVID‑19 Syndrome – (AI-PACS)

Mukherjee, Manali | $499,245

Ontario McMaster University 2021 CIHR Operating Grant

The coronavirus pandemic has severely affected healthcare systems and changed life as we know it, globally. In Canada alone, more than 1 million cases and >23000 deaths have been documented. Apart from the acute phase disease complications, it is now apparent that a significant proportion (15%) of patients who recover continue experiencing symptoms such as chronic fatigue, shortness of breath, joint pains, cognitive impairment (« brain fog »), etc for several months, if not for life. This syndrome has been labeled as « long-COVID » or Post-Acute COVID‑19 Syndrome (PACS) and can happen to anyone whether you’re young, old, healthy, or have a chronic illness. One can get it even if the COVID‑19 symptoms were mild. There is no confirmed cause as to why this happens. However, there is data to support that inappropriate activation of the immune system by the virus may play a role. While our immune system is programmed to protect us against foreign invaders (such as viruses), in this case, it is directed against elements of our own. The net result is autoimmunity, where the immune system produces autoantibodies that cause damage to the body. This may lead to the development of chronic and serious diseases like lupus, rheumatoid arthritis, vasculitis, scleroderma, and others. Our preliminary data show that more than half of patients post-recovery develop multiple autoantibodies. That said, it is not known if these patients will develop autoimmune diseases in the future. The aim of our study is to understand the exact impairment of the immune system, why these patients develop autoantibodies, characterize their impact on the clinical symptoms of PACS, and, potentially, identify ways to modify this. The study’s impact is significant since it is projected that 100000 Canadians will experience (or are already experiencing) this syndrome. Our team brings together several experts, both clinicians, and scientists, to guarantee the success of the project.

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