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COVID-19 in patients with myasthenia gravis: a single-center retrospective study in China

  • COVID-19
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Abstract

Background

Coronavirus disease 2019 (COVID-19) has been a great concern since 2019. Patients with myasthenia gravis (MG) may be at higher risk of COVID-19 and a more severe disease course. We examined the associations between COVID-19 and MG.

Methods

This single-center retrospective cohort study involved 134 patients who were diagnosed with MG from June 2020 to November 2022 and followed up until April 2023. They were divided into a COVID-19 group and non-COVID-19 group. Logistic regression analysis was used to detect factors potentially associating COVID-19 with MG.

Results

Of the 134 patients with MG, 108 (80.6%) had COVID-19. A higher number of comorbidities was significantly associated with an increased risk of COVID-19 (p = 0.040). A total of 103 patients (95.4%) had mild/moderate COVID-19 symptoms, and 4 patients (3.7%) were severe/critical symptoms (including 2 deaths). Higher age (p = 0.036), use of rituximab (p = 0.037), tumors other than thymoma (p = 0.031), Hashimoto’s thyroiditis (p = 0.011), more comorbidities (p = 0.002), and a higher baseline MG activities of daily living (MG-ADL) score (p = 0.006) were risk factors for severe COVID-19 symptoms. The MG-ADL score increased by ≥ 2 points in 16 (15.7%) patients. Dry cough and/or expectoration (p = 0.011), use of oral corticosteroids (p = 0.033), and use of more than one kind of immunosuppressant (p = 0.017) were associated with the increase of the post-COVID-19 MG-ADL score.

Conclusion

Most patients with MG have a mild course of COVID-19. However, patients with older age, many comorbidities, a high MG-ADL score, and use of a variety of immunosuppressants during COVID-19 may be more prone to severe symptoms.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

The study was supported by National Natural Science Foundation of China (82201550). Funding bodies did not play a role in the collection, analysis, and interpretation of data. Funding bodies did not contribute to the writing of this manuscript.

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Authors and Affiliations

  1. Neurology Department, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China

    Jiayi Li, Yiming Zheng, Yawen Zhao, Ran Liu, Hongjun Hao, Zhaoxia Wang, Yun Yuan & Feng Gao

  2. Department of Thoracic Surgery, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China

    Kang Qi & Gang Lin

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  1. Jiayi Li
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Contributions

Writing—original draft: Jiayi Li and Yiming Zheng; methodology: Jiayi Li and Yiming Zheng; data curation: Jiayi Li, Yiming Zheng, Kang Qi, and Gang Lin; formal analysis: Jiayi Li; writing—review and editing: Zhaoxia Wang, Yun Yuan, and Feng Gao; validation: Yawen Zhao, Ran Liu, and Hongjun Hao; supervision: Feng Gao.

Corresponding author

Correspondence to Feng Gao.

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Ethics approval

The study was approved by the Ethics Committee of Peking University First Hospital, and informed consent was obtained from all patients or their family members.

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The authors declare no competing interests.

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Jiayi Li and Yiming Zheng contributed equally as first authors.

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Li, J., Zheng, Y., Zhao, Y. et al. COVID-19 in patients with myasthenia gravis: a single-center retrospective study in China. Neurol Sci 45, 2969–2976 (2024). https://doi.org/10.1007/s10072-024-07518-4

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