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. 2022 Apr;65(4):447-452.
doi: 10.1002/mus.27497. Epub 2022 Feb 9.

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

Ozlem Gungor Tuncer  1 , Feza Deymeer  1
Affiliations

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

Ozlem Gungor Tuncer et al. Muscle Nerve. 2022 Apr.

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 in our study. 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 17 symptomatic patients, 11 had mild symptoms. They either had no treatment or received antivirals, antibiotics, and anticoagulants. Their myasthenia was well-controlled before 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 postsurgery myasthenic exacerbation before 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 affected patients. Immunosuppressive (IS) agents were generally continued. Hydroxychloroquine (HCQ) for COVID-19 was used in one patient.

Discussion: Most 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 before infection and absence of comorbidities likely affected the course of the infection favorably. IS did not influence the progression.

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

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Conflict of interest statement

None of the authors has any conflict of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Study flowchart. MG, myasthenia gravis; COVID‐19, coronavirus disease‐2019; PCR, polymerase chain reaction
See this image and copyright information in PMC

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