Impact of COVID-19 pandemic and lockdown in a cohort of myasthenia gravis patients in India

Kalita, Jayantee; Tripathi, Arvind; Dongre, Nikhil; Misra, Usha Kant

doi:10.1016/j.clineuro.2021.106488

Cited by 15 publications

(12 citation statements)

References 35 publications

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“…In this paper, we aimed to provide an overview of the impact of COVID-19 and vaccination programs in a tertiary-referral MG Centre. At the very beginning, in the first wave of the pandemic, worldwide social restrictions were the only solution for slowing the diffusion and the rapid spread of COVID-19 [ 41 ]. In a first study published during the first wave, we explored the impact of lockdown on patients affected by NMD [ 7 ]; as expected, the restrictions significantly reduced the patients’ overall autonomy and some patients refused clinical follow-up.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 in AChR Myasthenia Gravis and the Safety of Vaccines: Data from an Italian Cohort

Lupica

Stefano

Iacono

et al. 2022

Neurology International

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Background and aims. Patients with Myasthenia gravis (MG) are considered vulnerable as they may present with respiratory muscle weakness and because they are on immunosuppressive treatment; thereby, COVID-19 may have a detrimental effect on these patients. Vaccines against COVID-19 are currently available and it has been shown as they can prevent severe COVID-19 in vulnerable patients. Notwithstanding their efficacy, vaccine hesitancy has not been completely dispelled in the general population. Unfortunately, there is limited data about the safety of these vaccines in MG patients. The aims of this study are to evaluate the impact of COVID-19 in a MG cohort, the adherence to COVID-19 vaccination in Italy and vaccine safety in MG patients. Methods. A retrospective cohort study of MG patients attending the Neuromuscular Clinic of the University Hospital “Paolo Giaccone” of Palermo, Italy, was performed. Patients underwent telephone interviews with a dedicated questionnaire on SARS-CoV-2 vaccination and infection. Vaccine safety was assessed though the evaluation of vaccine-related adverse events (AEs) and comparisons of MG-ADL scores before and after vaccination. Patient worsening was defined as two or more point increases in MG-ADL scores. Results. From a total of 90 participants, 75 answered the questionnaire and 70.5% of them (n = 53) received the vaccine; ten patients did not receive vaccination and 3 patients were partially vaccinated. Among the vaccinated patients, about 45% (n = 24) experienced at least one AE, with a complete resolution within one week. No serious AEs and life-threatening conditions were observed. Globally, MG-ADL scores did not worsen after vaccination. Nine unvaccinated patients experienced SARS-CoV2 infection and four of them (44%) died—one patient required respiratory support, whereas three patients were asymptomatic. Conclusions. COVID-19 significantly impacted MG patients with an increase in mortality due to respiratory sequelae. Vaccines against SARS-CoV-2 showed good short-term safety in MG patients, who may take advantage of vaccination to avoiding life-threatening complications such as COVID-19 pneumonia.

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Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 in AChR Myasthenia Gravis and the Safety of Vaccines: Data from an Italian Cohort

Lupica

Stefano

Iacono

et al. 2022

Neurology International

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“…Deterioration in mental health during the pandemic was also observed in individuals with myasthenia gravis (MG) and MS. Individuals with MG experienced a rise in depression, anxiety and insomnia, and reduced quality of life [ 40 , 41 ]. Compared to healthy controls, individuals with MS reported higher psychological strain.…”

Section: Discussionmentioning

confidence: 99%

COVID-19-Related Burden and Risk Perception in Individuals with Chronic Inflammatory Demyelinating Polyneuropathy and Multifocal Motor Neuropathy: A Cross-Sectional Study

et al. 2022

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Introduction This study investigated the mental health burden of patients with chronic inflammatory demyelinating polyneuropathy (CIDP) or multifocal motor neuropathy (MMN) during the COVID-19 pandemic in comparison to matched healthy controls. Methods The cross-sectional study included 59 patients with a diagnosis of either CIDP or MMN and 59 propensity score matched healthy controls. All participants completed a survey including demographics, distress (distress thermometer), depressive symptoms (PHQ-2), generalized anxiety (GAD-7), COVID-19-related fear, and risk perception. Additionally, patients with CIDP or MMN were asked about the frequency and type of infections since treatment initiation. Results Patients with either CIDP or MMN reported experiencing reduced frequency or no differences in infection frequency since immune medication was initiated. Regarding COVID-19, patients with CIDP or MMN rated their risk of infection similar to healthy controls, while they expected a higher probability of the occurrence of symptoms, severe course, and dying of COVID-19. They reported increased depressive symptoms, generalized anxiety, and COVID-19-related fear in comparison to healthy controls. Conclusion Despite their personal experience of reduced frequency of infection since immune medication was initiated, patients with CIDP or MMN reported increased risk perception and prevalence of depressive symptoms, generalized anxiety, and COVID-19-related fear in comparison to healthy controls. This highlights the need for evidence-driven strategies to protect the mental health of this vulnerable group. Supplementary Information The online version contains supplementary material available at 10.1007/s40120-022-00359-3.

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“…Another autoimmune neurodegenerative disease which affects acetylcholine receptors from the level of the postsynaptic membrane of the end plate, Myasthenia gravis, was monitored through MG Quality of Life (MGQOL15), MG Activity of Daily Living (MGADL, Myasthenia Gravis Foundation of America staging (MGFA Scale), Hospital Anxiety and Depression Scale HADS) with a score range between 0-21, where increased values mean worsening depression and anxiety [36].…”

Section: Tools/variables Which Quantify Motor and Emotional Status At...mentioning

confidence: 99%

“…In another paper, 38 patients with moderate Myasthenia Gravis (not associated with COVID-19), were treated with prednisolone and azathioprine, and physical exercise training consisting of walking, yoga and moderate physical activity delivered through online platforms. Evaluation was carried out by specific tools: MGFA, MGQOL 15, MGADL, HADS and PSQI, which demonstrated worsening wellbeing life quality, anxiety and depression during home confinement [36].…”

Section: Tools/variables Which Quantify Motor and Emotional Status At...mentioning

confidence: 99%

“…Phone interviews were carried out about ADL during lockdown using the specific tools: PASE, HADS and PALs. Evaluation revealed worsening motor impairments with increasing dyskinesia, tremor, freezing of gait, instability stance, muscles pain, rigidity and cognitive disorders, which were augmented sleep dysfunction, depression, anxiety, feeling stressed, lack of concentration and attention [36]. In another paper, investigations were carried out in 832 patients with PD, who were performing moderate walking training for one hour/day.…”

Section: Tools/variables Which Quantify Motor and Emotional Status At...mentioning

confidence: 99%

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New Recovery Strategies in Motor and Cognitive Functions, before, during and after Home-Confinement COVID-19, for Healthy Adults and Patients with Neurodegenerative Diseases: Review

Bacanoiu

Danoiu

Marin

et al. 2022

JCM

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Distancing and confinement at home during the Coronavirus Disease 2019 (COVID-19) outbreak has led to worsening of motor and cognitive functions, both for healthy adults and for patients with neurodegenerative diseases. The decrease in physical activity, the cessation of the intervention of the recovery and the social distance imposed by the lockdown, has had a negative impact on the physical and mental health, quality of life, daily activities, as well as on the behavioral attitudes of the diet. The purpose of this paper was to evaluate the impact of decreasing physical activity and the affected emotional status in healthy adults and patients with neurodegenerative diseases in conditions imposed by the stay at home mandate of COVID-19, along with new interventions, such as telemedicine and telerehabilitation. These interventions include online surveys carried out in multi-languages, semi-structured interviews, intervention smartphones and interventions through online platforms, for instance: Google, WhatsApp, Twitter, ResearchGate, Facebook and LinkedIn. For this study, we selected original papers that were intensively processed using characteristics co-related with physical activity, mental wellbeing, sleep quality, good eating behavior and healthy lifestyle. By searching the last two years of literature, our review presents and demonstrates the benefit of online technological interventions in lockdown, which promote physical exercise patterns and rehabilitation techniques, for healthy adults and patients with neurodegenerative diseases, and the need to develop new strategic directions and governmental measures, designed procedures and health services, which are expected to improve the quality of life, the progress of physical and cognitive functions, mental health and wellbeing for all.

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Impact of COVID-19 pandemic and lockdown in a cohort of myasthenia gravis patients in India

Cited by 15 publications

References 35 publications

Impact of COVID-19 in AChR Myasthenia Gravis and the Safety of Vaccines: Data from an Italian Cohort

Impact of COVID-19 in AChR Myasthenia Gravis and the Safety of Vaccines: Data from an Italian Cohort

COVID-19-Related Burden and Risk Perception in Individuals with Chronic Inflammatory Demyelinating Polyneuropathy and Multifocal Motor Neuropathy: A Cross-Sectional Study

New Recovery Strategies in Motor and Cognitive Functions, before, during and after Home-Confinement COVID-19, for Healthy Adults and Patients with Neurodegenerative Diseases: Review

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