Myasthenie.com

Eur J Neurol. 2021 Jun 3. doi: 10.1111/ene.14951. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Myasthenia gravis (MG) patients could be a vulnerable group in the pandemic era of Coronavirus 2019 (COVID-19) mainly due to respiratory muscle weakness, older age, and long-term immunosuppressive treatment. We aimed to define factors predicting the severity of COVID-19 in MG patients and risk of MG exacerbation during COVID-19.

METHODS: We evaluated clinical features and outcomes after COVID-19 in 93 MG patients.

RESULTS: Thirty-five patients (38%) had severe pneumonia and we recorded 10 deaths (11%) due to COVID-19. Higher forced vital capacity (FVC) values tested before COVID-19 were shown as protective against severe infection CI 95% (0.934- 0.98) as well as good control of MG measured by quantified myasthenia gravis score CI95% (1.047 - 1.232). Long term chronic corticosteroid treatment worsened the course of COVID-19 in MG patients CI95% (1.784-111.43) and this impact was positively associated with dosage (p-value 0.005). Treatment using azathioprine CI95% (0.448 - 2.935), mycophenolate mofetil CI95% (0.91 - 12.515) and ciclosporin CI95% (0.029 - 2.212) did not influence the course of COVID-19. MG patients treated by rituximab had a high risk of death caused by COVID-19 CI95% (3.216 - 383.971). Exacerbation of MG during infection was relatively rare (15%) and was not caused by remdesivir, convalescent plasma or favipiravir CI95% (0.885 - 10.87).

CONCLUSIONS: As the most important predictors of severe COVID-19 in MG patients we identified unsatisfied condition of MG with lower FVC, previous long-term corticosteroid treament especially in higher doses, older age, the presence of cancer, and recent rituximab treatment.

PMID:34080271 | DOI:10.1111/ene.14951


Source: https://pubmed.ncbi.nlm.nih.gov/3408027 ... 0&v=2.14.4