Document Type : Original Article
Authors
- Masoud Etemadifar 1
- Mahsa Akafzadeh-Savari 2
- Mehri Salari 3
- Amirhossein Akhavan Sigari 2
- Sara Ebrahimi-Pelarti 2
- Nahad Sedaghat 2
- Koorosh Etemad 4
1 Department of Neurosurgery, Al-Zahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
2 Al-Zahra Research Institute, Al-Zahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
3 Department of Neurology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical sciences, Tehran, Iran
Abstract
Background: Coronavirus disease 2019 (COVID-19) is spreading rapidly and has affected millions of people worldwide. Comorbid diseases have complicated the course of infection and increased mortality. Myasthenia gravis (MG) affects the neuromuscular junctions (NMJs) and can compromise respiratory muscle action, leading to worse clinical outcomes in individuals infected with the COVID-19 theoretically. In this study, the aim is to assess the pattern of COVID-19 infection in patients with MG based on several factors.
Methods: This was a prospective cohort study following 150 patients with MG over a six-month period. The patients were monitored for the development of signs and symptoms of the COVID-19 infection.
Results: Comparison of the patients infected with COVID-19 with MG and those not infected was performed independently based on age, duration since MG diagnosis, status of thymectomy, and current clinical status of MG disease. Data analysis did not reveal increased susceptibility or increased severity of COVID-19 illness based the criteria assessed.
Conclusion: COVID-19 related deaths and susceptibility were not related to age, thymectomy status, and disease duration in patients with MG.
Keywords
- Lazzari C, Shoka A, Nusair A, Rabottini M. Psychiatry in time of COVID-19 pandemic. Psychiatr Danub 2020; 32(2): 229-35.
- Wenninger S, Schoser B. Myasthenia gravis: Current status of antibody diagnostics and aspects on refractory myasthenia gravis. Fortschr Neurol Psychiatr 2018; 86(9): 551-8. [In German].
- Anand P, Slama MCC, Kaku M, Ong C, Cervantes-Arslanian AM, Zhou L, et al. COVID-19 in patients with myasthenia gravis. Muscle Nerve 2020; 62(2): 254-8.
- Jacob S, Muppidi S, Guidon A, Guptill J, Hehir M, Howard JF, et al. Guidance for the management of myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) during the COVID-19 pandemic. J Neurol Sci 2020; 412: 116803.
- Restivo DA, Centonze D, Alesina A, Marchese-Ragona R. Myasthenia gravis associated with SARS-CoV-2 infection. Ann Intern Med 2020; 173(12): 1027-8.
- Wang Z, Yan Y. Immunopathogenesis in myasthenia gravis and neuromyelitis optica. Front Immunol 2017; 8: 1785.
- Yang L, Liu S, Liu J, Zhang Z, Wan X, Huang B, et al. COVID-19: Immunopathogenesis and Immunotherapeutics. Signal Transduct Target Ther 2020; 5(1): 128.
- Tan L, Wang Q, Zhang D, Ding J, Huang Q, Tang YQ, et al. Lymphopenia predicts disease severity of COVID-19: A descriptive and predictive study. Signal Transduct Target Ther 2020; 5(1): 33.
- Gomez-Rial J, Curras-Tuala MJ, Rivero-Calle I, Gomez-Carballa A, Cebey-Lopez M, Rodriguez-Tenreiro C, et al. Increased serum levels of sCD14 and sCD163 indicate a preponderant role for monocytes in COVID-19 immunopathology. Front Immunol 2020; 11: 560381.
- Zhou Y, Fu B, Zheng X, Wang D, Zhao C, Qi Y, et al. Pathogenic T-cells and inflammatory monocytes incite inflammatory storms in severe COVID-19 patients. Natl Sci Rev 2020; 7(6): 998-1002.
- Tan M, Liu Y, Zhou R, Deng X, Li F, Liang K, et al. Immunopathological characteristics of coronavirus disease 2019 cases in Guangzhou, China. Immunology 2020; 160(3): 261-8.
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