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Risk and Course of COVID-19 in Immunosuppressed Patients with Myasthenia Gravis
Frauke Geisendörfer
Ulrike Grittner
Sarah Hoffmann
Philipp Mergenthaler
Michael Schroeter
Tobias Ruck
Mark Pawlitzki
Franz Blaes
Julia Kaiser
Ulrike Schara
Adela Della Marina
Andrea Thieme
Tim Hagenacker
Christian Jacobi
Benjamin Berger
Peter P. Urban
Karl Christian Knop
Berthold Schalke
De-Hyung Lee
Petra Kalischewski
Heinz Wiendl
Andreas Meisel
出版
Universität
, 2023
URL
http://books.google.com.hk/books?id=aoph0AEACAAJ&hl=&source=gbs_api
註釋
Abstract: Background
Patients with myasthenia gravis (MG) are potentially prone for a severe COVID-19 course, but there are limited real-world data available on the risk associated with COVID-19 for patients with MG. Here, we investigate whether current immunosuppressive therapy (IST) influences the risk of SARS-CoV-2 infection and COVID-19 severity.
Methods
Data from the German myasthenia gravis registry were analyzed from May 2020 until June 2021 and included patient demographics, MG disease duration, comorbidities, current IST use, COVID-19 characteristics, and outcomes. Propensity score matching was employed to match MG patients with IST to those without, and multivariable binary logistic regression models were used to determine associations between IST with (1) symptomatic SARS-CoV-2 infection and (2) severe COVID-19 course, as measured by hospitalization or death.
Results
Of 1379 patients with MG, 95 (7%) patients (mean age 58 (standard deviation [SD] 18) presented with COVID-19, of which 76 (80%) received IST at time of infection. 32 patients (34%) were hospitalized due to COVID-19; a total of 11 patients (12%) died. IST was a risk factor for hospitalization or death in the group of COVID-19-affected MG patients (odds ratio [OR] 3.04, 95% confidence interval [CI] = 1.02-9.06, p = 0.046), but current IST was not associated with a higher risk for SARS-CoV-2 infection itself.
Discussion
In this national MG cohort study, current IST use was a risk factor for a severe disease course of COVID-19 but not for SARS-CoV-2 infection itself. These data support the consequent implementation of effective strategies to prevent COVID-19 in this high-risk group.
Trial registration information
German clinical trial registry (https://www.drks.de), DRKS00024099, first patient enrolled: February 4th, 2019