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. 2023 Apr;123(2):529-536.
doi: 10.1007/s13760-022-02121-w. Epub 2022 Oct 24.

COVID-19 infection and vaccination against SARS-CoV-2 in myasthenia gravis

Stojan Peric  1 , Milos Rankovic  2 , Ivo Bozovic  3 , Vanja Radosavljevic  2 , Ivan Marjanovic  4 , Ivana Basta  1 , Dragana Lavrnic  1
Affiliations

COVID-19 infection and vaccination against SARS-CoV-2 in myasthenia gravis

Stojan Peric et al. Acta Neurol Belg. 2023 Apr.

Abstract

Introduction: Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction which is typically presented with muscle weakness and excessive fatigability. Majority of MG patients require long-term immune suppression. Our aim was to analyze the frequency and severity of COVID-19 infection in MG patients, as well as the frequency of vaccinated MG patients against SARS-CoV-2.

Methods: We included 125 MG patients from the central Belgrade municipalities-60% females, age at MG onset 50.1 ± 19.7 years, age at testing 61.7 ± 16.8 years, anti-acetylcholine receptor (anti-AChR) positive 78% and muscle specific tyrosine kinase (MuSK) positive 8.6%.

Results: One-third of our MG patients had a COVID-19 infection and they were younger compared to those without verified COVID-19. Severe COVID-19 infection was registered in 28% of MG patients, mostly in elder subjects with comorbidities such as cardiac diseases and malignancies. MG worsening was noted in 21% of patients during/after COVID-19 and 42% had COVID-19 sequelae. Majority of MG patients were vaccinated against SARS-CoV-2 (almost 70%). Vaccination was more common among MG patients with diabetes and in those with a milder form of MG. The most common types of vaccines were Sinopharm (42%) and Pfizer-BioNTech (25.6%). Adverse events were observed in 36% of vaccinated patients, with flu-like symptoms (77%) and local reactions (13%) being the most common ones. MG worsening was noticed in 5 (5.8%) patients after vaccination.

Conclusion: COVID-19 has placed a significant new burden for MG patients. Elder MG patients and patients with comorbidities are in higher risk of having adverse outcome following SARS-CoV-2 infection. Percentage of vaccinated MG patients was higher than in general Serbian population.

Keywords: COVID-19 infection; Myasthenia gravis; SARS-CoV-2; Vaccination.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

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