J 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.

Basic information

Original name

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)

Authors

JAKUBIKOVA, Michala (203 Czech Republic, guarantor), Michaela TYBLOVA (203 Czech Republic), Adam TESAR (203 Czech Republic), Magda HORÁKOVÁ (203 Czech Republic, belonging to the institution), Daniela VLAŽNÁ (703 Slovakia, belonging to the institution), Rysankova RYSANKOVA (203 Czech Republic), Iveta NOVAKOVA (203 Czech Republic), Doleckova DOLECKOVA (203 Czech Republic), Dusek DUSEK (203 Czech Republic), Jiri PITHA (203 Czech Republic), Stanislav VOHÁŇKA (203 Czech Republic, belonging to the institution) and Josef BEDNAŘÍK (203 Czech Republic, belonging to the institution)

Edition

European Journal of Neurology, Oxford, Rapid Science Ltd. 2022, 1351-5101

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30210 Clinical neurology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 5.100

RIV identification code

RIV/00216224:14110/22:00125101

Organization unit

Faculty of Medicine

DOI

UT WoS

000715896100001

Keywords in English

corticosteroids; COVID-19; immunosuppression; myasthenia gravis; rituximab

Tags

Tags

International impact, Reviewed
Změněno: 16/2/2023 13:38, Mgr. Tereza Miškechová

Abstract

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.

Links

MUNI/A/1144/2021, interní kód MU
Name: Diagnostika a patofyziologie neuropatické bolesti a dalších symptomů a komorbidit neurologických onemocnění
Investor: Masaryk University
MUNI/A/1600/2020, interní kód MU
Name: Diagnostika a patofyziologie neuropatické bolesti (Acronym: PNB)
Investor: Masaryk University