I think you can follow Peertube channels and write comments but not post videos. And you can't access Mastodon nor Pixelfed.
Lemmy is centered on the concept of ActivityPub groups. While Mastodon etc are about individuals, they don't use that concept (with their toots) and since following accounts isn't implemented in Lemmy, there is no way to properly interact.
Though there are other software projects. MBin combines both. And Piefed wants to get there, eventually. They already hook into a few more things, but Mastodon or Pixelfed accounts currently aren't properly supported either. But Mastodon people can write replies to our posts.
It's a bit complicated. And I think ActivityPub is fairly low level and broad (I think). So it's really down to the individual implementation and whether two projects agree to do something in a compatible way. And write code for the specifics of some content types.