Miastenia gravis asociada a la infección por SARS-CoV-2: una conjunción de factores

Maresma, Laia Mas; Esteve, Oriol Barrachina; Vilasaró, Marta Navarro; Moreno-Ariño, Marc

doi:10.1016/j.regg.2020.08.004

Revista Española de Geriatría y Gerontología

2020

DOI: 10.1016/j.regg.2020.08.004

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Miastenia gravis asociada a la infección por SARS-CoV-2: una conjunción de factores

Laia Mas Maresma¹,

Oriol Barrachina Esteve

Marta Navarro Vilasaró

et al.

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Cited by 6 publications

(15 citation statements)

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“…With interest we read the article by Maresma et al about an 86yo male with a previous history of arterial hypertension, diabetes, atrial fibrillation, and hyperuricemia who was admitted for COVID-19 manifesting with bilateral pneumonia. 1 He was treated with azithromycin, ceftriaxone, and steroids intravenously. 1 On hospital day-4 he experienced generalised fatigue, proximal muscle weakness of the lower limbs, bilateral ptosis, hyporeflexia, and dysarthria.…”

mentioning

confidence: 99%

“… 1 He was treated with azithromycin, ceftriaxone, and steroids intravenously. 1 On hospital day-4 he experienced generalised fatigue, proximal muscle weakness of the lower limbs, bilateral ptosis, hyporeflexia, and dysarthria. 1 He was diagnosed with seronegative myasthenia gravis (MG) and treated with pyridostigmine, steroids, and immunoglobulins.…”

mentioning

confidence: 99%

“… 1 On hospital day-4 he experienced generalised fatigue, proximal muscle weakness of the lower limbs, bilateral ptosis, hyporeflexia, and dysarthria. 1 He was diagnosed with seronegative myasthenia gravis (MG) and treated with pyridostigmine, steroids, and immunoglobulins. 1 The study has a number of limitations and raises the following comments and concerns.…”

mentioning

confidence: 99%

“… 1 He was diagnosed with seronegative myasthenia gravis (MG) and treated with pyridostigmine, steroids, and immunoglobulins. 1 The study has a number of limitations and raises the following comments and concerns.…”

mentioning

confidence: 99%

“…We do not agree with the statement that no other cases of SARS-CoV-2 triggered MG have been reported. 1 The first study that demonstrated MG due to an infection with SARS-CoV-2 was published by Restivo et al who reported three cases of SARS-CoV-2 triggered MG. 4 Since then, SARS-CoV-2 triggered MG had been reported also by others. 5 …”

mentioning

confidence: 99%

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SARS-CoV-2 may unravel metabolic myopathy mistaken for myasthenia

Finsterer

Maeztu

2021

Revista Española de Geriatría y Gerontología

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mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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SARS-CoV-2 may unravel metabolic myopathy mistaken for myasthenia

Finsterer

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2021

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Efferent neuro-ophthalmic complications of coronavirus disease 2019

Dinkin

Sathi

2022

Current Opinion in Ophthalmology

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Purpose of reviewWe set out to describe efferent neuro-ophthalmological complications that have been reported in association with coronavirus disease 2019 (COVID-19) infection. We describe syndromes affecting ocular motility and elaborate on mechanisms of disease, including para-infectious inflammation, hypercoagulability, endothelial damage, and direct neurotropic viral invasion. Despite global vaccination programs, COVID-19 continues to pose an international threat that may rarely result in diplopia or nystagmus.Recent findingsEfferent complications include cranial nerve palsies leading to diplopia, either isolated or in association with Miller Fisher syndrome. Nystagmus has been observed in the setting of hemorrhagic acute necrotizing encephalopathy and brainstem infarcts, and opsoclonus syndrome has been described.SummaryObserved neuro-ophthalmic associations need to be confirmed through larger comparative studies. Meanwhile, the range of possible complications should be recognized by neurologists and ophthalmologists alike, to facilitate faster diagnosis and treatment of both COVID-19 and its neuro-ophthalmic manifestations.

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Complicações neuromusculares pela COVID-19: uma revisão sistemática de literatura

Lobato,

Diniz,

Miranda

et al. 2022

Rev. Med. (São Paulo)

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Introdução: O Coronavírus é um vírus zoonótico de RNA, tratando-se também de uma família de vírus que causam infecções respiratórias, em que um dos tipos conhecidos é o SARS-CoV-2, que é um novo coronavírus descrito no final de 2019, sendo responsável por provocar a doença chamada de COVID-19. Além do trato respiratório, tal patologia pode afetar vários sistemas orgânicos e dentre esses, o sistema neuromuscular tem sido apontado como alvo do SARS-CoV-2. Objetivo: Verificar se há relação entre a COVID-19 e o surgimento de doenças neuromusculares. Metodologia: Revisão sistemática pelo método PRISMA, com coleta de dados realizada nas bases PubMed e BVS, verificando a relação entre a COVID-19 e o surgimento ou intensificação das doenças neuromusculares. Os artigos coletados foram publicados entre janeiro de 2020 e março de 2021. Foram encontrados 1366 artigos e aprovados 56 para a revisão sistemática. Resultados: 56 estudos apontaram ligação entre a COVID-19 e o desenvolvimento de patologias neuromusculares, destacando-se: Síndrome de Guillain-Barré e suas variações (n=37), Miastenia de Gravis (n=4), Mielite (n=2). Discussão: Em relação a Síndrome de Guillain-Barré e sua associação com a COVID-19, observou-se que os principais sinais e sintomas neuromusculares relatados foram: déficits quantitativos dos reflexos (hiporreflexia ou arreflexia), parestesia, paralisia, diminuição da força muscular, dormência e formigamento. Por conseguinte, notou-se que há diversas relações entre a COVID-19 e o desenvolvimento de doenças ou síndromes neuromusculares. Conclusão: É possível perceber que há forte indícios da relação entre a fisiopatologia da COVID-19 e o surgimento de síndromes neuromusculares, sendo a Síndrome de Guillain-Barré a disfunção mais relatada em diferentes localidades do mundo. Nesse sentido, é interessante o desenvolvimento de pesquisas com maior tamanho amostral, bem como, necessidade de compreensão do mecanismo de ação viral sobre o sistema nervoso, a fim de obter tratamentos mais eficientes para esses quadros clínicos.

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Miastenia gravis asociada a la infección por SARS-CoV-2: una conjunción de factores

Cited by 6 publications

References 7 publications

SARS-CoV-2 may unravel metabolic myopathy mistaken for myasthenia

SARS-CoV-2 may unravel metabolic myopathy mistaken for myasthenia

Efferent neuro-ophthalmic complications of coronavirus disease 2019

Complicações neuromusculares pela COVID-19: uma revisão sistemática de literatura

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