2022
Predictive factors for a severe course of COVID-19 infection in myasthenia gravis patients with an overall impact on myasthenic outcome status and survival (Letter)
JAKUBIKOVA, Michala, Michaela TYBLOVA, Adam TESAR, Magda HORÁKOVÁ, Daniela VLAŽNÁ et. al.Základní údaje
Originální název
Predictive factors for a severe course of COVID-19 infection in myasthenia gravis patients with an overall impact on myasthenic outcome status and survival (Letter)
Autoři
JAKUBIKOVA, Michala (203 Česká republika, garant), Michaela TYBLOVA (203 Česká republika), Adam TESAR (203 Česká republika), Magda HORÁKOVÁ (203 Česká republika, domácí), Daniela VLAŽNÁ (703 Slovensko, domácí), Rysankova RYSANKOVA (203 Česká republika), Iveta NOVAKOVA (203 Česká republika), Doleckova DOLECKOVA (203 Česká republika), Dusek DUSEK (203 Česká republika), Jiri PITHA (203 Česká republika), Stanislav VOHÁŇKA (203 Česká republika, domácí) a Josef BEDNAŘÍK (203 Česká republika, domácí)
Vydání
European Journal of Neurology, Oxford, Rapid Science Ltd. 2022, 1351-5101
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30210 Clinical neurology
Stát vydavatele
Spojené státy
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 5.100
Kód RIV
RIV/00216224:14110/22:00125101
Organizační jednotka
Lékařská fakulta
UT WoS
000715896100001
Klíčová slova anglicky
corticosteroids; COVID-19; immunosuppression; myasthenia gravis; rituximab
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 16. 2. 2023 13:38, Mgr. Tereza Miškechová
Anotace
V originále
Background and purpose Myasthenia gravis (MG) patients could be a vulnerable group in the pandemic era of coronavirus 2019 (COVID-19) mainly due to respiratory muscle weakness, older age and long-term immunosuppressive treatment. We aimed to define factors predicting the severity of COVID-19 in MG patients and risk of MG exacerbation during COVID-19. Methods We evaluated clinical features and outcomes after COVID-19 in 93 MG patients. Results Thirty-five patients (38%) had severe pneumonia and we recorded 10 deaths (11%) due to COVID-19. Higher forced vital capacity (FVC) values tested before COVID-19 were shown to be protective against severe infection (95% CI 0.934-0.98) as well as good control of MG measured by the quantified myasthenia gravis score (95% CI 1.047-1.232). Long-term chronic corticosteroid treatment worsened the course of COVID-19 in MG patients (95% CI 1.784-111.43) and this impact was positively associated with dosage (p = 0.005). Treatment using azathioprine (95% CI 0.448-2.935), mycophenolate mofetil (95% CI 0.91-12.515) and ciclosporin (95% CI 0.029-2.212) did not influence the course of COVID-19. MG patients treated with rituximab had a high risk of death caused by COVID-19 (95% CI 3.216-383.971). Exacerbation of MG during infection was relatively rare (15%) and was not caused by remdesivir, convalescent plasma or favipiravir (95% CI 0.885-10.87). Conclusions As the most important predictors of severe COVID-19 in MG patients we identified unsatisfied condition of MG with lower FVC, previous long-term corticosteroid treatment especially in higher doses, older age, the presence of cancer, and recent rituximab treatment.
Návaznosti
MUNI/A/1144/2021, interní kód MU |
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MUNI/A/1600/2020, interní kód MU |
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