TABLE 2.
Comparison of our series to early reported series of Myasthenia Gravis patients with COVID‐19
| N Rein et al. 6 | Camelo‐Filho et al. 2 | Huber et al. 5 | Anand et al. 7 | Our study | |
|---|---|---|---|---|---|
| Number of patients | 3 | 15 | 4 | 5 | 5 |
| Gender (F/M) | 2/1 | 9/6 | 2/2 | 3/2 | 4/1 |
| Age in years, median (ranges) | 42 (38–66) | 61,3 | 36 (25–55) | 64 (42–90) | 54 (37–60) |
| Antibody status (number) | NS | AchR (10), Musk (1),SN (4) | AchR (3), SN (1) | AchR (4), Musk (1) | AchR (3), SN (2) |
| Thymectomy number (percentage) | 2 (66,66%) | 6 (40%) | 3 (75%) | 2 (40%) | 1 (20%) |
| Mean duration of MG in years (ranges), | 10 (1–4) | 9 (1–22) | 3.5 (2–6) | 4 (1–20) | 9 (3–15) |
| Comorbidities (number of patients) | Diabetes and hypertension (1), hypothyroidism (1). | Diabetes (4), hypertension and LES (1), asthma (1). | Basedow disease (1), Behçet disease, migraine, endocrinopathy and obesity (1), hypertension (1), obesity, and sleep apnea (1). | Dementia (1), Hepatitis B (1). | Obesity (1). |
| MGFA severity classification before COVID−19 infection (number of patients) | Complete remission (1),IIa (2) | I(5), IIa or IIb (9), III(1) | IIa (2),IIIb (1),V(1) | I(3), IIb (1), pharmacological remission(1) | I(1), IIa (3), IIIb(1). |
| Number of MG Exacerbation during COVID−19 infection (percentage) | 1 (33,33%) | 13 (86,66%), 11 needing M.V | 2 (50%), 1 needing M.V. | 1 (25%) | 2 (40%). |
| Treatment change of MG during hospitalization for COVID−19 infection (number of patients) | Initiation and/or maintenance of IV Ig (2), increased prednisone dose (1). | Initiation of IV Ig (1), Plasmapheresis (4), IS therapy withheld (5). | Increased dose of pyridostigmine (1), Prior IS therapy withheld (1). | IS therapy withheld (3), Prednisone dose maintained or increased (2), prednisone dose reduced (1). | Maintenance of prior IS therapy (4), Iv Ig (1). |
| Specific therapy of COVID−19 infection (number of patients) | HCQ, Iopinavir and ritonavir (1). | Macrolides (11), Oseltamivir (2). | AZM (3), TZB/PIP (1). | HCQ (3), AZM (3), CTX (1). | AZM (4), LEV (1). |
| Clinical outcomes (number of patients) | Discharged or recovered at home with improvement) (3). | 13/15 admissions in an ICU (11 needing M.V). | Discharged at home with full recovery (1), with residual mild to moderate signs (2), Prolonged M.V. period, weakness of pharyngeal muscles (1) | Discharged at home with improvement (4), requires of ongoing VM (1). | Discharged or recovered at home with improvement) (4), death (1). |
| Mortality, number of patients (percentage) | 0 | 4 (26,66%) | 0 | 0 | 1 (20%) |
Abbreviations: AchR, acetylcholine receptors; COVID‐19, coronavirus disease 19; CTX, Ceftriaxone; F, female; HCQ, hydroxychloroquine; ICU, intensive care unit; IS, immunosuppressive; IV Ig, intravenous immunoglobulin; LEV, levofloxacin; M, male; MG, myasthenia gravis; MGFA, myasthenia gravis foundation of America; Musk, muscle specific kinase; MV, mechanical ventilation.