Myasthenia Gravis and COVID-19: Clinical Characteristics and Outcomes

Filho, Antonio Edvan Camelo; Silva, André Macedo Serafim; Estephan, Eduardo de Paula; Zambon, A A; Mendonça, Rodrigo Holanda; Souza, Paulo Victor Sgobbi de; Pinto, Wladimir B.V.R.; Oliveira, Acary Souza Bullé; Dangoni-Filho, Iron; Pouza, Ana Flávia Pincerno; Valério, Berenice Cataldo Oliveira; Zanoteli, Edmar

doi:10.3389/fneur.2020.01053

Cited by 83 publications

(135 citation statements)

References 15 publications

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“…Acute respiratory distress (ARDS) seen in COVID-19 coupled with respiratory muscle failure in MG crises may result in a dire prognosis. A retrospective Brazilian study conducted from March 15 to May 31, 2020, among 15 adult MG patients with COVID-19, showed a 30% mortality rate [ 100 ]. The most common presentation was dyspnea, followed by fever.…”

Section: Neuromuscular Junction Disordersmentioning

confidence: 99%

Peripheral Nervous System Manifestations Associated with COVID-19

Andalib

Biller

Napoli

et al. 2021

Curr Neurol Neurosci Rep

136

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Purpose of Review The present review discusses the peripheral nervous system (PNS) manifestations associated with coronavirus disease 2019 (COVID-19). Recent Findings Nerve pain and skeletal muscle injury, Guillain-Barré syndrome, cranial polyneuritis, neuromuscular junction disorders, neuro-ophthalmological disorders, neurosensory hearing loss, and dysautonomia have been reported as PNS manifestations in patients with COVID-19. Summary Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19. COVID-19 has shown syndromic complexity. Not only does SARS-CoV-2 affect the central nervous system but also it involves the PNS. The PNS involvement may be due to dysregulation of the immune system attributable to COVID-19. Here we review the broad spectrum of PNS involvement of COVID-19.

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Section: Neuromuscular Junction Disordersmentioning

confidence: 99%

Peripheral Nervous System Manifestations Associated with COVID-19

Andalib

Biller

Napoli

et al. 2021

Curr Neurol Neurosci Rep

136

View full text Add to dashboard Cite

show abstract

“…On the other hand, 4 out of 5 patients who died did not receive immunosuppressant agents. [ 5 ] Immunosuppressant therapy is likely to be beneficial in COVID-19 cases with MG by reducing hyperinflammation and cytokine storms. [ 10 ] Therefore, corticosteroid and immunosuppressant agents should be continued in MG patients with or without SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Octaviana¹,

Yugo²,

Safri³

et al. 2021

eNeurologicalSci

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Background During the COVID-19 pandemic, patients with myasthenia gravis (MG) are most likely to be affected by this situation. Corticosteroids and immunosuppressant agents increase the risk of severe infection. Furthermore, viral infection and some medications in COVID-19 may exacerbate MG symptoms. Case description We presented three patients with MG who contracted COVID-19. All of the patients had a favourable outcome. Only one patient who was not treated with corticosteroids or immunosuppressant therapy experienced deterioration of MG symptoms, while the other patients who received immunosuppressant therapy did not develop MG exacerbation. Surprisingly, azithromycin did not provoke myasthenic crisis (MC) in patients with normal MGFA classification. Conclusion Using immunosuppressant agents may not lead to MG deterioration and may not be related to unfavourable outcomes.

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“…Dear Sirs, Novel Corona Virus Disease 2019 (COVID-19) poses an unpredictable risk for patients with myasthenia gravis (MG) due to potentially additive effects of bulbar and respiratory muscle weakness and viral lung affection [1]. MG manifestations in conjunction with COVID-19, reported since the outbreak of the pandemic, were highly variable [2] and ranged from isolated ocular symptoms [3] to severe exazerbations with respiratory failure [1,4,5] and lethal outcomes of approximately 30% have been reported in a recent series of 15 consecutive patients [6]. Maintenance of standard immunosuppressive treatment is recommended in mild-tomoderate disease [7]; however, information about the management and outcome of patients with severe generalized MG treated with immune-depleting agents such as rituximab is still limited.…”

mentioning

confidence: 99%