Myasthenia Gravis Crisis Triggered by Covid-19

Fares, Elie-Jacques; Tayyar, Ralph; Pathak, Kriti; Damiano, Christopher; Kuntz, Catherine

doi:10.1016/j.chest.2020.08.688

Cited by 5 publications

(4 citation statements)

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“…On similar lines, worsening myasthenia crisis can be ascribed to various kinds of infection, and COVID-19 is no exception [ 31 , 32 ]. In a series of 91 patients with myasthenia gravis, myasthenic worsening required rescue therapy in 40% who were diagnosed with COVID-19 [ 33 ].…”

Section: Muscle Involvement In Covid-19mentioning

confidence: 99%

COVID-19 and Myositis: What We Know So Far

et al. 2021

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Purpose Myositis as a rare manifestation of COVID-19 is only recently being reported. This review examines the current literature on COVID-19-induced myositis focusing on etiopathogenesis, clinical presentations, diagnostic practices, and therapeutic challenges with immunosuppression, and the difficulties experienced by rheumatologists in established myositis in the COVID-19 era. Recent Findings COVID-19 is associated with a viral myositis attributable to direct myocyte invasion or induction of autoimmunity. COVID-19-induced myositis may be varied in presentation, from typical dermatomyositis to rhabdomyolysis, and a paraspinal affliction with back pain. It may or may not present with acute exponential elevations of enzyme markers such as creatine kinase (CK). Virus-mediated muscle inflammation is attributed to ACE2 (angiotensin-converting enzyme) receptor–mediated direct entry and affliction of muscle fibers, leading on to innate and adaptive immune activation. A greater recognition of the stark similarity between anti-MDA5-positive myositis with COVID-19 has thrown researchers into the alley of exploration — finding common etiopathogenic basis as well as therapeutic strategies. For patients with established myositis, chronic care was disrupted during the pandemic with several logistic challenges and treatment dilemmas leading to high flare rates. Teleconsultation bridged the gap while ushering in an era of patient-led care with the digital transition to tools of remote disease assessment. Summary COVID-19 has brought along greater insight into unique manifestations of COVID-19-related myositis, ranging from direct virus-induced muscle disease to triggered autoimmunity and other etiopathogenic links to explore. A remarkable shift in the means of delivering chronic care has led patients and caregivers worldwide to embrace a virtual shift with teleconsultation and opened doorways to a new era of patient-led care.

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Section: Muscle Involvement In Covid-19mentioning

confidence: 99%

COVID-19 and Myositis: What We Know So Far

et al. 2021

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“…SARS-CoV-2 may trigger an MG crisis (111) . Restivo et al describe three patients [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , [86] , [87] , [88] , [89] , [90] , [91] , [92] , [93] , [94] , [95] , [96] , [97] , [98] , [99] , [100] , [101] , [102] , [103] , [104] , [105] , [106] , [107] , [108] , [109] , [110] , [111] , [112] , [113] , [114] , [115] , [116] , [117] , [118] , [119] , [120] , [121] , [122] , [123] , [124] , [125] , [126] , [127] , [128] , [129] , [130] , [131]...…”

Section: Covid-19 and Autoimmunityunclassified

SARS-CoV-2 triggering autoimmune diseases

et al. 2022

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“…There have been some case reports regarding COVID-19 in MG patients. [ [4] , [5] , [6] , [7] ] The course of disease and outcomes varied greatly. More than 50% of MG patients hospitalized due to COVID-19 had severe courses and that led to death in 30% of patients.…”

Section: Introductionmentioning

confidence: 99%

“…More than 50% of MG patients hospitalized due to COVID-19 had severe courses and that led to death in 30% of patients. [ 5 ] COVID-19 may precipitate myasthenic crisis [ 6 ]. However, some cases had favourable outcomes.…”

Section: Introductionmentioning

confidence: 99%

Case series: COVID-19 in patients with mild to moderate myasthenia gravis in a National Referral Hospital in Indonesia

Octaviana¹,

Yugo²,

Safri³

et al. 2021

eNeurologicalSci

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Background During the COVID-19 pandemic, patients with myasthenia gravis (MG) are most likely to be affected by this situation. Corticosteroids and immunosuppressant agents increase the risk of severe infection. Furthermore, viral infection and some medications in COVID-19 may exacerbate MG symptoms. Case description We presented three patients with MG who contracted COVID-19. All of the patients had a favourable outcome. Only one patient who was not treated with corticosteroids or immunosuppressant therapy experienced deterioration of MG symptoms, while the other patients who received immunosuppressant therapy did not develop MG exacerbation. Surprisingly, azithromycin did not provoke myasthenic crisis (MC) in patients with normal MGFA classification. Conclusion Using immunosuppressant agents may not lead to MG deterioration and may not be related to unfavourable outcomes.

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Myasthenia Gravis Crisis Triggered by Covid-19

Cited by 5 publications

References 0 publications

COVID-19 and Myositis: What We Know So Far

COVID-19 and Myositis: What We Know So Far

SARS-CoV-2 triggering autoimmune diseases

Case series: COVID-19 in patients with mild to moderate myasthenia gravis in a National Referral Hospital in Indonesia

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