Deadly Synergy: between Postcovid & Posttrauma Stress Syndrome in Areas of Armed Conflicts in COVID-I9 Era (Note)

Postcovid syndrome affects 5-20% of all patients with symp-tomatic Covid-I9 infection, resulting in temporary or perma-nent disability for next weeks or months. The commonest syn-dromes after long Covid-I9, (or chronic fatigue syndrome after Covid, or as synonymum postcovid syndrome) are psychic or psychosomatic disorders known under the name Depression and Anxiety Syndrome. After the unrest and armed conflicts during the Covid era, clients or patients, mainly migrants of war, are also exposed to chronic post trauma syndrome related to previous or recent de-struction of infrastructure, temporary homelesness and escape from affected regions/country. Cumulation of those 2 syndro-mes may have devastating consequences to both, individual health and economic losses due to permanent working and eco-nomy disabilities and consumption of health and social funds. After the unrest and armed conflicts during Covid era,clients or patients, mainly migrants of war, are also exposed to chronic post trauma syndrome related to previous or recent destruction of infrastructure, temporary homelesness and escape from af-fected regions/country.

COVID-19 in patients with myasthenia gravis

Various infections can frequently lead to the exacerbation of myasthenia gravis (MG). COVID-19 infection characterized by lung impairment with respiration failure, massive infl ammatory reaction and high mortality may lead to worsening of many neuromuscular disorders including MG. Published series of patients with MG and COVID-19 are considerably variable and dill er in disease severity and selected therapeutic approach. In our group of 11 MG patients, substantial worsening was present in 3 patients, and in 4 there was a mild worsening of clinical myasthenic symptoms. In 3 patients, we used high doses of methylprednisolone intravenously, in 2 patients, the oral doses of prednisone were increased to 40 mg/ 60 mg a day, 1 patient was treated with intravenous immunoglobulin (2 g/ kg), and 1 was treated with remdesivir. An 88-year-old woman was dia gnose d with MG after COVID-19 infection. A 77-year-old man died after 6 days of mechanical ventilation. COVID-19 infection leads to an exacerbation of clinical symptoms in a large proportion of MG patients with ventilation disorder due to increased muscle fatigue and inflammatory changes in the lung parenchyma.