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Muscle Nerve . Clinical course and outcome of an outpatient clinic population with myasthenia gravis and COVID-19

tetano

Editor, Senior Moderator
Muscle Nerve


. 2022 Jan 17.
doi: 10.1002/mus.27497. Online ahead of print.
Clinical course and outcome of an outpatient clinic population with myasthenia gravis and COVID-19


Ozlem Gungor Tuncer[SUP] 1 [/SUP], Feza Deymeer[SUP] 1 [/SUP]



Affiliations

Abstract

Introduction/aims: Coronavirus disease 2019(COVID-19) may have a more severe course in patients with myasthenia gravis(MG). We aimed to assess severity of the infection and factors contributing to its severity in a group of MG patients, most of whom were not hospitalized.
Methods: One hundred forty outpatients with MG followed between March 2020 and April 2021 were included. Patients were asked to respond to a brief questionnaire in person, by telemedicine or through electronic messages.
Results: Nineteen patients tested positive for COVID-19 by polymerase chain reaction. Two were asymptomatic. Of the seventeen symptomatic patients, eleven had mild symptoms. They either had no treatment or received antivirals, antibiotics and anticoagulants. Their myasthenia was well-controlled prior to infection and was unaffected by COVID-19. Three patients with moderate COVID-19 required hospitalization, but not intensive care, and had full recovery. Three other patients, the oldest in the cohort, had severe disease: One patient with a post-surgery myasthenic exacerbation prior to the infection needed intensive care without intubation, but recovered completely; two morbidly obese patients with comorbidities required intubation and died. Corticosteroids were increased in four of the six moderate/severely involved patients. Immunosuppressives(IS) were generally continued. Hydroxychloroquine(HCQ) for COVID-19 was used in one patient.
Discussion: The majority of the patients had mild COVID-19 and all but two patients recovered. The design of the study made it possible to capture mild cases. Having well-controlled MG prior to infection and absence of comorbidities likely affected the course of the infection favorably. IS did not influence the progression. This article is protected by copyright. All rights reserved.

Keywords: COVID-19; infection; mild; myasthenia gravis; treatment.
 
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