On the 8th September 2025, The Lancet Infectious Diseases published the following paper, ‘Autoantibodies in long COVID: a systematic review.' Read extracts and a summary below, alongside comment from Dr Charles Shepherd, ME Association Hon. Medical Adviser, highlighting the need for more robust evidence.
Summary using AI
- A systematic review of 44 studies (7,571 participants) found that 71% reported a link between autoantibodies and long COVID, highlighting potential biomarkers like antinuclear antibodies and those targeting G protein-coupled receptors.
- Despite these findings, variability in study designs and definitions limits conclusions, and larger studies are needed to confirm the diagnostic and prognostic role of these autoantibodies in long COVID.
Extracts
This systematic review synthesises current evidence on the association between autoantibodies and long COVID, with the goal of evaluating their prognostic and diagnostic utility.
Studies published in the PubMed and MEDLINE databases between Jan 1, 2020, and June 10, 2025, were considered. Study selection and quality assessment were done independently by two researchers. Of the 1113 publications screened, 44 studies met the inclusion criteria, with a total of 7571 participants, including 3372 individuals with long COVID.
31 (71%) studies reported an association between autoantibodies and long COVID; however, there was substantial heterogeneity in study design, type and timing of antibody measurements, and long COVID definitions.
Several autoantibodies have been associated with long COVID occurrence, symptoms, and severity. Antinuclear antibodies, and autoantibodies targeting G protein-coupled receptors and chemokines, have emerged as potential biomarkers for aiding in the diagnosis, prognosis, and assessment of disease severity in long COVID.
However, larger studies are needed to confirm the diagnostic and prognostic utility of these autoantibodies in the context of long COVID.
ME Association Comment
Is Long Covid an autoimmune disease?
Autoimmune diseases occur when the body's immune system produces antibodies – called autoantibodies – that have harmful effects on various body tissues.
Examples include coeliac disease, myasthenia gravis and pernicious anaemia.
In the case of both Long Covid and ME/CFS there is patient and research evidence of autoantibodies being present in some people.
However, this evidence is not sufficiently robust or consistent to conclude that these are autoimmune diseases.
This is a useful new review in The Lancet of the evidence of autoimmunity in Long Covid.
Dr Charles Shepherd,
Trustee and Hon. Medical Adviser to the ME Association,
Member of the 2018-2021 NICE guideline on ME/CFS committee,
Member of the 2002 Chief Medical Officer's Working Group on ME/CFS
