Clinical features and outcomes of patients with myasthenia gravis affected by COVID-19: A single-center study

https://doi.org/10.1016/j.clineuro.2022.107441Get rights and content

Highlights

  • Symptoms of myasthenia gravis (MG) may be exacerbated by COVID-19.

  • Immunosuppressive therapy was continued during COVID-19 infection.

  • Plasmapheresis with IVIg was well tolerated in patients with MG affected by COVID-19.

  • The most of hospitalized patients were discharged from the hospital without requiring nursing care and rehabilitation.

Abstract

Introduction

Myasthenia Gravis (MG) is an autoimmune disorder that can exacerbate for various reasons including infections. In this study, we describe clinical symptoms, outcomes, and management of MG patients affected by COVID-19 infection.

Methods

This observational retrospective study was performed on patients previously diagnosed as MG, presenting with COVID-19 in the clinic or emergency department between April 2020 and August 2021. The clinical data, outcome, and therapeutic interventions were assessed in 83 patients with MG and COVID-19 infection.

Results

Seventy-seven patients performed PCR testing for COVID-19, of which 73 (94.8 %) were positive. Seven patients had the positive serologic test for COVID-19 (IgG and IgM). Fifty-seven (68.7 %) patients had lung involvement. Thirty-five (42.1 %) of patients were admitted to the hospital. Twelve (14.5 %) patients needed hospitalization in an intensive care unit (ICU), with a mean stay of 7.36 ± 5.6 days (rang: 2–20 days). Four (4.8 %) patients were intubated and required mechanical ventilation. Sixteen (19.3 %) patients experienced an exacerbation of myasthenia gravis and were treated with PLEX (n = 2), IVIG (n = 7), and intravenous (IV) methylprednisolone (n = 7). The outcome was favorable in 79 patients and fatal in four patients, three of whom had other comorbidities. One patient died due to severe COVID-19 involvement.

Conclusion

The findings from our study demonstrated that patients with previous MG concurrence with COVID-19 have favorable clinical outcomes. Most patients did not need to be hospitalized and more than 80 % of patients did not display MG exacerbation.

Keywords

Myasthenia gravis
COVID-19
Immunosuppression
Outcome

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