COVID-19 Outcomes in Myasthenia Gravis Patients

October 6, 2022

Researchers in Iran conducted an observational retrospective study to measure COVID-19 outcomes in patients previously diagnosed with Myasthenia Gravis (MG). COVID-19 infections can cause systemic inflammation, severe respiratory and neurological symptoms, and trigger a dysregulated immune response. These complications can lead to worse clinical outcomes for MG patients. 

In total, 83 patients were included in the study between April 2020 and August 2021, with the average patient being 45 years old. 67 patients were classified as having generalized MG and 16 patients were classified as having ocular MG. 35 patients had co-morbidities including hypothyroidism, Systemic Lupus Erythematosus, Immunodeficiency disease, Rheumatoid Arthritis, Multiple Sclerosis, and Sarcoidosis. 

During the study period, 35 of 83 (42.1%) patients were admitted to the hospital, with 12 patients entering the ICU and 4 patients being intubated. 16 patients experienced exacerbated MG symptoms. “Two patients with exacerbation died and two patients were discharged with rehabilitation or skills nursing… There was no significant difference between exacerbation and clinical outcome of discharge patients after hospitalization.”

Researchers highlight that there was no significant relationship between the rates of hospitalization and co-morbidities. Regarding MG therapy at the time of infection, “there was no significant difference between those who stopped or continued [the oral immunosuppressant azahioprine] regarding hospitalization, MG exacerbation, and death.” At the time of the study, 70 patients were taking prednisone, 34 were taking a second oral immunosuppressant, and 12 patients were taking Rituximab. Two patients were receiving  monthly intravenous immunoglobulin. Overall, researchers found clinical outcomes to be “favorable” within this cohort as 80% of patients did not experience exacerbated MG symptoms, and the majority of patients were not hospitalized.