COVID-19 Infection Among Patients With Myasthenia Gravis Impacts Hospital Stay

Individuals with myasthenia gravis (MG) who have tested positive for COVID-19 have longer hospital stays, according to a study published in BMC Neurology.

MG is an autoimmune disease that can cause fluctuating weakness in the voluntary muscles, affecting neuromuscular junction. This is due to the immune system attacking acetylcholine receptors—they’re integral in how the nerves and muscles communicate and contract. Patients with MG often rely on immunosuppressants to help inhibit the body’s immune response. However, these medications can put this patient population at higher risk for infections, such as COVID-19.

The objective of the current study was to assess how COVID-19 infection affects patients with MG.

This study included 27 individuals with MG and who tested positive for COVID-19 (mean age 64.33±18.42 years), as well as 64 individuals with MG without COVID-19 infection (mean age 63.23±18.60 years). All data were taken from Cerner Real-World Data via Cerner’s HealtheDataLab tool. Extracted information included demographic characteristics (ethnicity, race, and gender), as well as comorbidities, complications, and first reported data of condition. A Pearson’s chi-squared test and a two-sample t-test were used to calculate statistical significance.

Using the database, the researchers also collected the start date and end date of medications that were prescribed after patients received a COVID-19 test result. Medications included immunoglobulin intravenous, methylprednisolone, prednisone, mycophenolate mofetil, and pyridostigmine.

Among those who tested positive for COVID-19, cases of pneumonia (n=13), septic shock (n=9), and acute respiratory failure (n=10) occurred. Of the 4 individuals diagnosed with an exacerbation, 2 died, 1 was discharged to a skilled nursing facility, and 1 was discharged home. Among those hospitalized between the 2 groups (n=13), those with COVID-19 experienced a significantly longer stay (8.28 days; n=7) than those in the non-COVID-19 set (4.33 days; n=6; P =.007).

The researchers also noted individuals infected with COVID-19 who had comorbidities, including hypertension, diabetes mellitus, cardiovascular disease, and respiratory diseases, may be at a higher risk of developing complications compared with individuals without comorbidities.

Limitations to this study included a lack of available public data, as well as a lack of seropositivity results and demographic localization of healthcare facilities in the United States.

“Our study utilized the de-identifed real-world data from the CERNER database, and the data was analyzed to report the characteristics of the patients and the outcomes,” the researchers stated.

Reference

Digala LP, Prasanna S, Rao P, Qureshi AI, Govindarajan R. Impact of COVID-19 infection among myasthenia gravis patients- a Cerner Real-World Data™ study. Published online January 27, 2022. BMC Neurol. doi:10.1186/s12883-022-02564-x