Fig. 2.

Autoimmunity is one mechanism by which SARS-CoV-2 might trigger autonomic dysfunction. Activation of the innate and adaptive immune responses contributes to inflammation and autoimmunity. The production of neuroactive and vasoactive autoantibodies leads to persistent activation of their corresponding receptors. Mechanisms of virus-induced autoimmunity include molecular mimicry, bystander activation, epitope spreading, and B lymphocyte immortalization Autoimmunity caused by long COVID impacts cell function, exacerbate immune-related symptoms, or initiate new symptoms of autonomic dysfunction. Abbreviations: GPCR: G-protein-coupled receptor.