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People with autoimmune rheumatic diseases are significantly more likely to develop long COVID than the general population, according to a large U.S. study. Researchers found a 56% higher risk in this group, with certain patients — including those on rituximab or steroids, or those with Sjögren's disease — at even greater risk. Vaccination and early antiviral treatment remain key prevention tools.
Patients with autoimmune rheumatic diseases face a notably higher chance of developing long COVID compared to people without these conditions, according to a large retrospective study published in Arthritis & Rheumatology. Researchers analyzed data from over 187,000 patients across the U.S. using the National COVID Cohort Collaborative (N3C), tracking outcomes from infections recorded between September 2021 and December 2023.
The study found that autoimmune patients had a 56% higher risk of long COVID (2.8% vs. 1.5% in matched controls). Certain subgroups were at particularly elevated risk, including those who experienced severe acute COVID-19, had pre-existing lung disease or obesity, or were treated with rituximab or glucocorticoids before infection. Patients with Sjögren's disease also showed heightened vulnerability.
Key Takeaways:
Why it matters: For rheumatologists and their patients, this study provides much-needed clarity on long COVID risk — and underscores that prevention strategies like vaccination and careful medication management aren't just about avoiding acute illness, but also about reducing the burden of lasting symptoms.
