COVID-19 Presentation in Association with Myasthenia Gravis: A Case Report and Review of the Literature

Abstract

Currently, there are scarce data on how COVID-19 affects people with myasthenia gravis. Theoretically, there is a higher risk of experiencing severe manifestations of COVID-19 due to the common use of immunosuppressive drugs and potential respiratory failure in relation to respiratory muscle weakness. This is one of the early cases of COVID-19 reported in association with myasthenia gravis. Here, we highlight the prognosis, discuss the pathophysiological mechanisms, and prompt the consideration of convalescent plasma therapy in myasthenia gravis patients with concomitant COVID-19.

New onset of ocular myasthenia gravis in a patient with COVID-19: a novel case report and literature review

“…A few case reports have described COVID-19 infection in patients with pre-existing myasthenia gravis [2,[7][8][9][10][11][12][13]. However, to the best of our knowledge, there have been no reported cases of ocular myasthenia gravis being triggered by COVID-19 infection.…”

COVID-19 neutralizing antibody-based therapies in humoral immune deficiencies: A narrative review

“…Immunodeficiency syndromes, being characterized by a blunted endogenous antibody response to infectious agents, including COVID-19, are the ideal setting for evaluating the clinical effect of CP [ [37] , [38] , [39] , [40] , [41] , [42] , [43] ]. Regarding the primary immunodeficiency, a recent review pre-published by Senefeld and colleagues [ 36 ], after a systematic search strategy, identified in the literature 11 patients (1 with autosomal agammaglobulinemia, 6 with X-linked agammaglobulinemia and 4 with common variable immunodeficiency).…”

“…Patients with acquired immunodeficiencies and COVID-19 are also at increased risk of morbidity and mortality due to the B- and T-cell depletion associated with the autoimmune disorders and to the common use immunosuppressive therapy. Aksoy and Oztugan [ 42 ] reported the case of a 46-year-old woman with myasthenia gravis treated with immunosuppressive drugs with severe COVID-19. The use of CP resulted in a rapid clinical improvement, thus avoiding the need for the planned invasive mechanical ventilation.…”

Case series: COVID-19 in patients with mild to moderate myasthenia gravis in a National Referral Hospital in Indonesia

“…There have been some case reports regarding COVID-19 in MG patients. [ [4] , [5] , [6] , [7] ] The course of disease and outcomes varied greatly. More than 50% of MG patients hospitalized due to COVID-19 had severe courses and that led to death in 30% of patients.…”

“…However, some cases had favourable outcomes. [ 4 ] [ 7 ] Here, we present three MG patients admitted with COVID-19 between July and October 2020. To the best of our knowledge, this is the first reported case series of resolved COVID-19 in MG patients in South-East Asia.…”