Clinical characteristics and outcomes of COVID-19 infection among myasthenia gravis patients in a national referral hospital in Indonesia

Abstract

Introduction. Due to their immunocompromised state from immunosuppressive therapy and respiratory efficiency, patients with Myasthenia Gravis (MG) are more likely to get infected with COVID-19. Currently, reports on MG patients exposed with COVID-19 in Indonesia are still limited. Therefore, this study was conducted to determine the clinical characteristics and outcomes of MG patients infected with COVID-19, especially in Jakarta, Indonesia. Methods. It is a retrospective study of MG patients in a National Referral Hospital in Indonesia from September 2021 to December 2022. The data obtained includes demographics, medical history, clinical characteristics, and severity of MG assessed by MG composite scale (MGCS), Myasthenia Gravis Foundation of America (MGFA) classification, symptoms, and therapy. Results. Of the 8 patients, 7 patients were female. The range of age at COVID-19 onset was 28-62 years old. On admission to the hospital, 2 patients were mild MG, 2 patients were moderate MG, 3 patients with severe MG, and one patient could not be identified because the patient came in an unconscious state. Five patients were classified as moderate COVID-19, two patients had severe COVID-19, and one patient was classified as critical COVID-19. Most patients experience MG exacerbation or require oxygen support during hospitalization. Only one patient deceased while receiving treatment at the emergency room, while the rest improved and were discharged home. Conclusion. MG patients exposed with COVID-19 tend to experience moderate, severe, and critical COVID-19 symptoms. However, with proper management of the infection and other comorbidities, MG patients with COVID-19 may achieve favorable outcome.

Keywords

• myasthenia gravis
• covid-19
• myasthenia gravis foundation of america
• myasthenia gravis composite scale