The Role of IL-21 on the Incidence of Autoimmune Disease in COVID-19 Patients

Septyana Eka Rahmawati (Master Program in Immunology, Postgraduate School, Universitas Airlangga, Campus B, Surabaya, Indonesia)
Theresia Indah Budhy Sulisetyawati (Department of Oral Pathology and Maxillofacial, Faculty of Dental Medicine, Universitas Airlangga)
Jusak Nugraha (Department of Clinical Pathology, Universitas Airlangga Institute of Tropical Disease)
Rian Anggi Destiawan (Department of Medical Laboratory Technology, Universitas dr. Soebandi)

Clinical Practices and Hospital Management
Vol. 2 No. 1 (2026): Clinical Practices and Hospital Management

SARS-CoV-2 is a virus that is causing the coronavirus disease 2019 (COVID-19) pandemic that is currently still ongoing. Clinical similarities between COVID-19 patients and symptoms suggest a definite association with SARS-CoV-2. Therefore, it is necessary to carry out an analysis based on the literature. Search articles based on keywords “COVID-19”, “SARS-COV-2”, IL-21, “Tfh cells with years 2019-2021. Here we stand about SARS-CoV-2 which may cause autoimmunity in COVID-19 patients. IL-21 is a pro-inflammatory cytokine that occurs in SARS-CoV-2 and autoimmune infections. IL-21 is capable of eliciting autocrine and paracrine features. When IL-21 observes NK cells, Treg cells, epithelial cells, mast cells, B cells and dendritic cells, it becomes paracrine. Autocrine features when IL-21 promotes NKT cells, Th17 cells, CD4 T cells, CD8 T cells and tfh cells. The increased autocrine and paracrine levels of IL-21 found in some COVID-19 patients have contributed to the autoimmune development of COVID-19 infection. The role of IL-21 has a hyperinflammatory reaction which is a key role in the occurrence of autoimmune in COVID-19 patients.