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Clinical features and outcomes of patients with myasthenia gravis affected by COVID-19: A single-center study
Narges Karimi1, Farzad Fatehi2, Ali Asghar Okhovat2
1Immunogenetics Research Center, School of Medicine, Mazandaran University of Medical Sciences, Sari, the Islamic Republic of Iran; Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, the Islamic Republic of Iran; Iranian Neuromuscular Research Center (INMRC), Tehran University of Medical Sciences, Tehran, the Islamic Republic of Iran.
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.
Insights
Patients with myasthenia gravis (MG) and COVID-19 generally experienced favorable outcomes. Most MG patients did not require hospitalization and over 80% did not have a myasthenia gravis exacerbation during their COVID-19 infection.
Area of Science:
- Neurology
- Infectious Diseases
- Autoimmune Disorders
Background:
- Myasthenia Gravis (MG) is an autoimmune condition where infections can trigger exacerbations.
- Understanding the impact of COVID-19 on MG patients is crucial for management.
Purpose of the Study:
- To describe the clinical symptoms, outcomes, and management strategies for patients diagnosed with Myasthenia Gravis who contracted COVID-19.
- To assess the impact of COVID-19 infection on Myasthenia Gravis disease activity.
Main Methods:
- An observational retrospective study was conducted on 83 patients with a prior diagnosis of Myasthenia Gravis who presented with COVID-19.
- Clinical data, outcomes, and treatments were analyzed for patients diagnosed between April 2020 and August 2021.
Main Results:
- Of 83 patients, 73 tested positive for COVID-19 via PCR. Lung involvement was observed in 68.7% of patients.
- 14.5% required intensive care unit (ICU) admission, and 4.8% needed mechanical ventilation.
- 19.3% experienced Myasthenia Gravis exacerbation, treated with PLEX, IVIG, or IV methylprednisolone. Overall outcomes were favorable in 79 patients.
Conclusions:
- Patients with concurrent Myasthenia Gravis and COVID-19 infections demonstrate favorable clinical outcomes.
- The majority of Myasthenia Gravis patients in this cohort did not require hospitalization or experience disease exacerbation due to COVID-19.
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