Impact of Coronavirus Disease 2019 in a French Cohort of Myasthenia Gravis
Guilhem Solé, Stéphane Mathis, Diane Friedman, Emmanuelle Salort‐Campana, Céline Tard, Françoise Bouhour, Armelle Magot, Djillali Annane, Bernard Clair, Gwendal Le Masson, Antoine Soulages, Fanny Duval, Louis Carla, Marie‐Hélène Violleau, Tiphaine Saulnier, Sandrine Ségovia-Kueny, Léa Kern, Jean‐Christophe Antoine, Guillemette Beaudonnet, Frédérique Audic, Laurent Kremer, Jean‐Baptiste Chanson, Aleksandra Nadaj‐Pakleza, Tanya Stojkovic, Pascal Cintas, Marco Spinazzi, Alexandra Foubert‐Samier, Shahram Attarian
Abstract
OBJECTIVE: To describe the clinical characteristics and outcomes of coronavirus disease 2019 (COVID-19) among patients with myasthenia gravis (MG) and identify factors associated with COVID-19 severity in patients with MG. METHODS: The CO-MY-COVID registry was a multicenter, retrospective, observational cohort study conducted in neuromuscular referral centers and general hospitals of the FILNEMUS (Filière Neuromusculaire) network (between March 1, 2020, and June 8, 2020), including patients with MG with a confirmed or highly suspected diagnosis of COVID-19. COVID-19 was diagnosed based on a PCR test from a nasopharyngeal swab or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serology, thoracic CT scan, or typical symptoms. The main outcome was COVID-19 severity based on location of treatment/management (home, hospitalized in a medical unit, or in an intensive care unit). We collected information on demographic variables, general history, and risk factors for severe COVID-19. Multivariate ordinal regression models were used to identify factors associated with severe COVID-19 outcomes. RESULTS: 0.004); factors that were not associated included sex, MG duration, and medium MGFA classes (≤IIIb). The type of MG treatment had no independent effect on COVID-19 severity. CONCLUSIONS: This registry-based cohort study shows that COVID-19 had a limited effect on most patients, and immunosuppressive medications and corticosteroids used for MG management are not risk factors for poorer outcomes. However, the risk of severe COVID-19 is elevated in patients with high MGFA classes (odds ratio, 102.6 [4.4-2,371.9]). These results are important for establishing evidence-based guidelines for the management of patients with MG during the COVID-19 pandemic.