Clinical Features of COVID-19 Infection in Patients with Myasthenia Gravis: a Real-world Retrospective Study

Overview

Journal Front Public Health

Specialty Public Health

Date 2024 Sep 11

PMID 39257951

Authors

Hui-Ning Li

Xiao-Na Xu

Ying-Hui Qin

Rui Liu

Wen-Yue Guo

Xiao-Yu Huang

Mo-Li Fan

Lin-Jie Zhang

Yuan Qi

Chao Zhang

Li Yang

Fu-Dong Shi

Chun-Sheng Yang

Affiliations

Soon will be listed here.

Abstract

Objective: We investigated the risk factors associated with severe or critical Coronavirus disease 2019 (COVID-19) infection due to the Omicron variant in patients with myasthenia gravis (MG) and determined the potential effect of COVID-19 on myasthenic exacerbation during the Omicron pandemic.

Methods: This retrospective study included 287 patients with MG in Tianjin, China. Clinical data of the patients were collected using electronic questionnaires, databases, and clinical records.

Results: The overall infection rate was 84.7%. Advanced age, comorbidities, generalized phenotype, and MG instability were drivers of COVID-19 severity, and post-COVID-19 myasthenic exacerbation. The concurrent use of a steroid-sparing agent did not affect COVID-19 susceptibility or severity. It did lower the risk of myasthenic exacerbation after COVID-19 infection. Patients with severe COVID-19 experienced myasthenic exacerbation earlier than patients with non-severe infection ( < 0.001). The severity of COVID-19 (Hazards Ratio = 3.04, 95% CI: 1.41-6.54, = 0.004) and the clinical phenotype (Hazards Ratio = 3.29, 95% CI: 1.63-6.63, < 0.001) emerged as independent risk factors for early MG exacerbation.

Conclusion: Generally, patients with MG appear to be susceptible to the Omicron strains. Immunotherapy for MG did not increase COVID-19 susceptibility or severity. We do not advocate an immediate cessation of ongoing immunosuppressive treatments once a COVID-19 infection is diagnosed. Instead, a judicious evaluation of the risks and benefits, tailored to each individual, is recommended.

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