tetano
Editor, Senior Moderator
Muscle Nerve
. 2023 Jun 16.
doi: 10.1002/mus.27919. Online ahead of print. COVID-19 infection in myasthenia gravis: Clinical course and outcomes
Eleanor V Thomas[SUP] 1 [/SUP], Gabriela Bou[SUP] 1 [/SUP], Shawn Barton[SUP] 1 [/SUP], Spencer Hutto[SUP] 1 [/SUP], Rocio Garcia-Santibanez[SUP] 1 [/SUP]
Affiliations
Introduction/aims: Myasthenia gravis (MG) patients have been predicted to have high rates of coronavirus disease-2019 (COVID-19) complications due to frequent involvement of respiratory muscles in MG and frequent use of immunosuppressive therapies. We investigated outcomes of MG patients infected with SARS-CoV-2 to identify risk factors for exacerbation and severe disease.
Methods: This was a retrospective analysis of 39 MG patients with SARS-CoV-2 infection from January March 1, 2020 to October 25, 2021 at Emory University. Patients' records were queried for demographic data, MG history, and COVID-19 treatments and hospitalizations.
Results: At the time of infection, 8 of 39 were vaccinated, 30 of 39 unvaccinated, and 1 unknown. Average age was 52.6 years. Twenty-seven patients were receiving immunomodulatory treatments at the time of infection. Thirty-five of 39 were symptomatic, 21 were hospitalized, and 7 required ventilations. MG exacerbations occurred in 5 and were treated with therapeutic plasma exchange (n = 1), intravenous immunoglobulin (IVIg) (n = 1), and prednisone taper (n = 5). Four hospitalized patients died from COVID-related lung injuries. No deaths were attributed to MG exacerbation; however, one patient receiving IVIg for MG exacerbation had a pulmonary embolism. There were no deaths in fully vaccinated patients, and only one vaccinated patient was admitted to the intensive care unit.
Discussion: High rates of COVID-19 complications and death were observed in this cohort of MG patients. Some patients with MG and COVID-19 also had an exacerbation during infection. Further studies are needed to determine whether MG patients are at higher risk for complications than the rest of the population.
Keywords: acetylcholine receptor; disease severity; myasthenia gravis; weakness.
. 2023 Jun 16.
doi: 10.1002/mus.27919. Online ahead of print. COVID-19 infection in myasthenia gravis: Clinical course and outcomes
Eleanor V Thomas[SUP] 1 [/SUP], Gabriela Bou[SUP] 1 [/SUP], Shawn Barton[SUP] 1 [/SUP], Spencer Hutto[SUP] 1 [/SUP], Rocio Garcia-Santibanez[SUP] 1 [/SUP]
Affiliations
- PMID: 37326164
- DOI: 10.1002/mus.27919
Introduction/aims: Myasthenia gravis (MG) patients have been predicted to have high rates of coronavirus disease-2019 (COVID-19) complications due to frequent involvement of respiratory muscles in MG and frequent use of immunosuppressive therapies. We investigated outcomes of MG patients infected with SARS-CoV-2 to identify risk factors for exacerbation and severe disease.
Methods: This was a retrospective analysis of 39 MG patients with SARS-CoV-2 infection from January March 1, 2020 to October 25, 2021 at Emory University. Patients' records were queried for demographic data, MG history, and COVID-19 treatments and hospitalizations.
Results: At the time of infection, 8 of 39 were vaccinated, 30 of 39 unvaccinated, and 1 unknown. Average age was 52.6 years. Twenty-seven patients were receiving immunomodulatory treatments at the time of infection. Thirty-five of 39 were symptomatic, 21 were hospitalized, and 7 required ventilations. MG exacerbations occurred in 5 and were treated with therapeutic plasma exchange (n = 1), intravenous immunoglobulin (IVIg) (n = 1), and prednisone taper (n = 5). Four hospitalized patients died from COVID-related lung injuries. No deaths were attributed to MG exacerbation; however, one patient receiving IVIg for MG exacerbation had a pulmonary embolism. There were no deaths in fully vaccinated patients, and only one vaccinated patient was admitted to the intensive care unit.
Discussion: High rates of COVID-19 complications and death were observed in this cohort of MG patients. Some patients with MG and COVID-19 also had an exacerbation during infection. Further studies are needed to determine whether MG patients are at higher risk for complications than the rest of the population.
Keywords: acetylcholine receptor; disease severity; myasthenia gravis; weakness.