SARS-CoV-2 and Autoimmunity: From Myocarditis to Arrhythmia and Cardiac Death

ABSTRACT

Background: Clinical attention has focused recently on an unexplained insurgence of Cardiovascular Diseases (CVDs) in concomitance with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. Here, this study aimed at defining the possible role of autoimmune cross-reactivity and immunologic memory as mechanisms that might link the viral infection to CVDs. Methods: Human proteins that, when altered, associate with CVDs were searched for pentapeptide immune determinants that are shared with SARS-CoV-2 spike glycoprotein (gp) and also recur in common pathogens to which the general population is frequently exposed. Results: Comparative sequence analyses show that 1) a high level of peptide sharing exists between SARS-CoV-2 spike gp and human proteins related to CVDs;2) the shared peptides are endowed with an immunological potential because they are also part of experimentally validated SARS-CoV-2 spike gp-derived epitopes, and 3) most of the shared peptides are also present in infectious pathogens to which population, in general, has been already exposed. Conclusion: Peptide sharing and cross-reactivity appear to be, respectively, the molecular platform and the basic mechanism linking SARS-CoV-2 infection to CVDs, with the past history of the individual's infections having a role in determining and specifying the immune response as well as the pathologic autoimmune sequelae.