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Impact of Coronavirus Disease 2019 in a French Cohort of Myasthenia Gravis.
Solé, Guilhem; Mathis, Stéphane; Friedman, Diane; Salort-Campana, Emmanuelle; Tard, Céline; Bouhour, Françoise; Magot, Armelle; Annane, Djillali; Clair, Bernard; Le Masson, Gwendal; Soulages, Antoine; Duval, Fanny; Carla, Louis; Violleau, Marie-Hélène; Saulnier, Tiphaine; Segovia-Kueny, Sandrine; Kern, Léa; Antoine, Jean-Christophe; Beaudonnet, Guillemette; Audic, Frédérique; Kremer, Laurent; Chanson, Jean-Baptiste; Nadaj-Pakleza, Aleksandra; Stojkovic, Tanya; Cintas, Pascal; Spinazzi, Marco; Foubert-Samier, Alexandra; Attarian, Shahram.
  • Solé G; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Mathis S; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Friedman D; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Salort-Campana E; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Tard C; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Bouhour F; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Magot A; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Annane D; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Clair B; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Le Masson G; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Soulages A; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Duval F; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Carla L; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Violleau MH; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Saulnier T; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Segovia-Kueny S; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Kern L; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Antoine JC; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Beaudonnet G; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Audic F; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Kremer L; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Chanson JB; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Nadaj-Pakleza A; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Stojkovic T; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Cintas P; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Spinazzi M; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Foubert-Samier A; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
  • Attarian S; From the Referral Center for Neuromuscular Diseases AOC (G.S., S.M., G.L.M., A.S., F.D., L.C., M.-H.V.) and ALS Center (S.M., G.L.M., A.S., L.C.), Nerve-Muscle Unit, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux; Department of Intensive Care (D.F., D.A., B.C.), Raymon
Neurology ; 96(16): e2109-e2120, 2021 04 20.
Artículo en Inglés | MEDLINE | ID: covidwho-1223789
ABSTRACT

OBJECTIVE:

To describe the clinical characteristics and outcomes of coronavirus disease 2019 (COVID-19) among patients with myasthenia gravis (MG) and identify factors associated with COVID-19 severity in patients with MG.

METHODS:

The CO-MY-COVID registry was a multicenter, retrospective, observational cohort study conducted in neuromuscular referral centers and general hospitals of the FILNEMUS (Filière Neuromusculaire) network (between March 1, 2020, and June 8, 2020), including patients with MG with a confirmed or highly suspected diagnosis of COVID-19. COVID-19 was diagnosed based on a PCR test from a nasopharyngeal swab or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serology, thoracic CT scan, or typical symptoms. The main outcome was COVID-19 severity based on location of treatment/management (home, hospitalized in a medical unit, or in an intensive care unit). We collected information on demographic variables, general history, and risk factors for severe COVID-19. Multivariate ordinal regression models were used to identify factors associated with severe COVID-19 outcomes.

RESULTS:

Among 3,558 patients with MG registered in the French database for rare disorders, 34 (0.96%) had COVID-19. The mean age at COVID-19 onset was 55.0 ± 19.9 years (mean MG duration 8.5 ± 8.5 years). By the end of the study period, 28 patients recovered from COVID-19, 1 remained affected, and 5 died. Only high Myasthenia Gravis Foundation of America (MGFA) class (≥IV) before COVID-19 was associated with severe COVID-19 (p = 0.004); factors that were not associated included sex, MG duration, and medium MGFA classes (≤IIIb). The type of MG treatment had no independent effect on COVID-19 severity.

CONCLUSIONS:

This registry-based cohort study shows that COVID-19 had a limited effect on most patients, and immunosuppressive medications and corticosteroids used for MG management are not risk factors for poorer outcomes. However, the risk of severe COVID-19 is elevated in patients with high MGFA classes (odds ratio, 102.6 [4.4-2,371.9]). These results are important for establishing evidence-based guidelines for the management of patients with MG during the COVID-19 pandemic.
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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: SARS-CoV-2 / COVID-19 / Miastenia Gravis Tipo de estudio: Estudio de cohorte / Estudio experimental / Estudio observacional / Estudio pronóstico Límite: Adulto / Anciano / Humanos / Masculino / Middle aged País/Región como asunto: Europa Idioma: Inglés Revista: Neurology Año: 2021 Tipo del documento: Artículo

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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: SARS-CoV-2 / COVID-19 / Miastenia Gravis Tipo de estudio: Estudio de cohorte / Estudio experimental / Estudio observacional / Estudio pronóstico Límite: Adulto / Anciano / Humanos / Masculino / Middle aged País/Región como asunto: Europa Idioma: Inglés Revista: Neurology Año: 2021 Tipo del documento: Artículo