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Characteristics, treatment, and outcomes of Myasthenia Gravis in COVID-19 patients: A systematic review.
Abbas, Alzhraa Salah; Hardy, Nicole; Ghozy, Sherief; Dibas, Mahmoud; Paranjape, Geeta; Evanson, Kirk W; Reierson, Natalie L; Cowie, Kathryn; Kamrowski, Shelby; Schmidt, Scarlett; Tang, Yutao; Davis, Amber R; Touchette, Jillienne C; Kallmes, Kevin M; Hassan, Ameer E; Tarchand, Ranita; Mehta, Mansi; Pederson, John M; Abdelmegeed, Mohamed.
  • Abbas AS; Minia University (Faculty of Medicine), Minia, Egypt.
  • Hardy N; Nested Knowledge, St. Paul, MN, United States.
  • Ghozy S; Mansoura University (Neurosurgery Department), Mansoura, Egypt; El Sheikh Zayed Specialized Hospital (Neurosurgery Department), Giza, Egypt.
  • Dibas M; Sulaiman Al Rajhi University (College of Medicine), Qassim, Saudi Arabia.
  • Paranjape G; Superior Medical Experts, St. Paul, MN, United States.
  • Evanson KW; Superior Medical Experts, St. Paul, MN, United States.
  • Reierson NL; Nested Knowledge, St. Paul, MN, United States.
  • Cowie K; Nested Knowledge, St. Paul, MN, United States.
  • Kamrowski S; Nested Knowledge, St. Paul, MN, United States.
  • Schmidt S; Nested Knowledge, St. Paul, MN, United States.
  • Tang Y; Nested Knowledge, St. Paul, MN, United States.
  • Davis AR; Superior Medical Experts, St. Paul, MN, United States.
  • Touchette JC; Superior Medical Experts, St. Paul, MN, United States.
  • Kallmes KM; Nested Knowledge, St. Paul, MN, United States.
  • Hassan AE; Valley Baptist Medical Center (Department of Neuroradiology), Harlingen, TX, United States.
  • Tarchand R; Nested Knowledge, St. Paul, MN, United States.
  • Mehta M; Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India.
  • Pederson JM; Nested Knowledge, St. Paul, MN, United States; Superior Medical Experts, St. Paul, MN, United States.
  • Abdelmegeed M; Superior Medical Experts, St. Paul, MN, United States. Electronic address: mohamed.abdelmegeed@supedit.com.
Clin Neurol Neurosurg ; 213: 107140, 2022 02.
Article in English | MEDLINE | ID: covidwho-1654200
ABSTRACT

OBJECTIVE:

Recent studies suggest that the clinical course and outcomes of patients with coronavirus disease 2019 (COVID-19) and myasthenia gravis (MG) are highly variable. We performed a systematic review of the relevant literature with a key aim to assess the outcomes of invasive ventilation, mortality, and hospital length of stay (HLoS) for patients presenting with MG and COVID-19.

METHODS:

We searched the PubMed, Scopus, Web of Science, and MedRxiv databases for original articles that reported patients with MG and COVID-19. We included all clinical studies that reported MG in patients with confirmed COVID-19 cases via RT-PCR tests. We collected data on patient background characteristics, symptoms, time between MG and COVID-19 diagnosis, MG and COVID-19 treatments, HLoS, and mortality at last available follow-up. We reported summary statistics as counts and percentages or mean±SD. When necessary, inverse variance weighting was used to aggregate patient-level data and summary statistics.

RESULTS:

Nineteen studies with 152 patients (mean age 54.4 ± 12.7 years; 79/152 [52.0%] female) were included. Hypertension (62/141, 44.0%) and diabetes (30/141, 21.3%) were the most common comorbidities. The mean time between the diagnosis of MG and COVID-19 was7.0 ± 6.3 years. Diagnosis of COVID-19 was confirmed in all patients via RT-PCR tests. Fever (40/59, 67.8%) and ptosis (9/55, 16.4%) were the most frequent COVID-19 and MG symptoms, respectively. Azithromycin and ceftriaxone were the most common COVID-19 treatments, while prednisone and intravenous immunoglobulin were the most common MG treatments. Invasive ventilation treatment was required for 25/59 (42.4%) of patients. The mean HLoS was 18.2 ± 9.9 days. The mortality rate was 18/152 (11.8%).

CONCLUSION:

This report provides an overview of the characteristics, treatment, and outcomes of MG in COVID-19 patients. Although COVID-19 may exaggerate the neurological symptoms and worsens the outcome in MG patients, we did not find enough evidence to support this notion. Further studies with larger numbers of patients with MG and COVID-19 are needed to better assess the clinical outcomes in these patients.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Myasthenia Gravis Type of study: Reviews / Systematic review Topics: Long Covid Limits: Adolescent / Adult / Child / Female / Humans / Male / Middle aged / Young adult Language: English Journal: Clin Neurol Neurosurg Year: 2022 Document Type: Article Affiliation country: J.CLINEURO.2022.107140

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Myasthenia Gravis Type of study: Reviews / Systematic review Topics: Long Covid Limits: Adolescent / Adult / Child / Female / Humans / Male / Middle aged / Young adult Language: English Journal: Clin Neurol Neurosurg Year: 2022 Document Type: Article Affiliation country: J.CLINEURO.2022.107140