Myasthenia Gravis and COVID 19: Case series

ABSTRACT

Background: Till date, more than 49 million people have been affected by COVID 19. There are special concerns with regards to myasthenia gravis (MG) patients one is immune suppression increasing their susceptibility to infection and second infections exacerbating MG. We describe our experience with 17 MG patients who had COVID 19 and their outcomes. Methods: Seventeen patients with MG who developed COVID 19 were identified from our database at Houston Methodist Hospital. Results: Out of the 17, 15 patients had generalized MG and 2 patients had ocular MG. Twelve patients (70%) were hospitalized. Four patients (23%) died. Four patients recovered with residual COVID 19 related complications. Nine of the patients were on more than one immune suppressant medication. Seven patients (41%) had MG exacerbation. The type of immune suppressants and steroids did not seem to affect outcomes of COVID 19. Patients treated with intravenous immunoglobulin for MG exacerbation had variable COVID 19 outcomes. Results: In our case series, 6 patients experienced MG exacerbation. The outcomes with relation to COVID 19 were variable and being on immune suppressants did not confer any benefit. The outcomes were not affected by the type of immune suppression.