Autoimmune Patients Face Higher Long COVID Risk

A large U.S. study found adults with autoimmune rheumatic diseases developed long COVID more often than matched peers after infection.

Updated on Nov. 2, 2026 in Arthritis

Autoimmune Patients Face Higher Long COVID Risk

A large U.S. study found that patients with autoimmune rheumatic diseases had a 1.5-fold higher risk of long COVID than matched controls. The retrospective analysis used National COVID Cohort Collaborative data and was published in Arthritis & Rheumatology, affecting people with these conditions who were infected with SARS-CoV-2.

Why it matters

People with autoimmune rheumatic diseases already live with immune dysregulation, fatigue, and pain, and many take immune-suppressing medicines, so an added long COVID burden matters for their daily function and care planning. The finding adds population-level evidence to a question that has been difficult to measure in this group.

This retrospective cohort study drew on N3C data covering patients with a first documented SARS-CoV-2 infection between September 2021 and December 2023, followed through December 2024. Long COVID prevalence was 2.8% among autoimmune rheumatic disease patients versus 1.5% among matched controls, an adjusted hazard ratio of 1.56. Because the design is observational, it shows association rather than cause.

The players

Arthritis & Rheumatology

A peer-reviewed journal from the American College of Rheumatology that publishes research on arthritis and autoimmune rheumatic diseases.

National COVID Cohort Collaborative (N3C)

A national U.S. data resource that aggregates electronic health records to support COVID-19 research, including long COVID.

The details

Researchers compared outcomes for patients with autoimmune rheumatic diseases against matched controls using electronic records from the National COVID Cohort Collaborative. Long COVID was identified either by a specific diagnostic code or by a clinical visit occurring 28 to 365 days after infection. Patients exposed to rituximab or glucocorticoids before infection showed higher long COVID risk, and the study also found elevated risk in people with severe COVID-19, lung disease, obesity, and Sjögren's disease.

September 2021: start of the window for first documented infections in the study.
December 2023: end of the window for first documented infections.
December 2024: end of patient follow-up.

Health Landscape

Work using the National COVID Cohort Collaborative has become a key source for tracking long COVID across large U.S. patient populations. This study adds to that record by identifying autoimmune rheumatic disease as a group with a measurably higher long COVID burden.

If you have an autoimmune rheumatic condition, it is worth discussing your long COVID risk and your vaccination status with your rheumatologist. The study's population-level findings suggest that people with these conditions may benefit from closer attention to post-infection symptoms.

The takeaway

Autoimmune rheumatic disease patients in this large U.S. study had a higher rate of long COVID than matched controls. COVID-19 vaccination is recommended for people with autoimmune conditions, so ask your physician whether your vaccines are current.