These challenges are due to the uncertainty about the origin of the virus, its rapid transmission, the difference in racial susceptibility, the wide variety of clinical presentations, the conflict in diagnosis, the rapid mutations that continuously elaborate, the disparity of the treatment regimens in the different parts of the world, and the high morbidity and mortality rates. The coronavirus disease 2019 (COVID-19), with its global pandemic, which started with the first reported case in December 2019, is a real challenge for humanity. This review discusses the mutual relation between COVID-19 and autoimmune diseases, their interactive effects on each other, the role of the COVID-19 vaccine in triggering autoimmune diseases, the factors affecting the severity of COVID-19 in patients suffering from autoimmune diseases, and the different ways to minimize the risk of COVID-19 in patients with autoimmune diseases. Consequently, COVID-19 and its vaccine may trigger the development of many autoimmune diseases in a predisposed patient. The immunogenic effects of SARS-CoV-2 are due to the sizeable viral RNA molecules with interrupted transcription increasing the pool of epitopes with increased chances of molecular mimicry and interaction with the host immune system, the overlap between some viral and human peptides, the viral induced-tissue damage, and the robust and complex binding between sACE-2 and SARS-CoV-2 S protein. Several human tissue antigens showed a strong response with antibodies directed against many severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) proteins, such as SARS-CoV-2 S, N, and autoimmune target proteins. Nevertheless, in some patients, the immune reaction becomes out of control with the development of autoimmune diseases. This immune response is usually controlled and terminated once the infection is aborted. After viral infection, the immune system can recognize the viral antigens presented by the immune cells. Despite being primarily a respiratory illness, COVID-19 can affect nearly every human body tissue, causing many diseases. Coronavirus disease 2019 (COVID-19) is a real challenge for humanity with high morbidity and mortality.
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