Stascheit, Frauke ORCID: 0000-0001-5306-7880, Grittner, Ulrike ORCID: 0000-0003-2595-0224, Hoffmann, Sarah ORCID: 0000-0001-9549-2594, Mergenthaler, Philipp, Schroeter, Michael, Ruck, Tobias, Pawlitzki, Mark, Blaes, Franz, Kaiser, Julia, Schara, Ulrike, Della-Marina, Adela, Thieme, Andrea, Hagenacker, Tim, Jacobi, Christian, Berger, Benjamin ORCID: 0000-0003-2654-2898, Urban, Peter P., Knop, Karl Christian, Schalke, Berthold, Lee, De-Hyung, Kalischewski, Petra, Wiendl, Heinz and Meisel, Andreas ORCID: 0000-0001-7233-5342 (2023). Risk and course of COVID-19 in immunosuppressed patients with myasthenia gravis. J. Neurol., 270 (1). S. 1 - 13. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1432-1459

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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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Stascheit, FraukeUNSPECIFIEDorcid.org/0000-0001-5306-7880UNSPECIFIED
Grittner, UlrikeUNSPECIFIEDorcid.org/0000-0003-2595-0224UNSPECIFIED
Hoffmann, SarahUNSPECIFIEDorcid.org/0000-0001-9549-2594UNSPECIFIED
Mergenthaler, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schroeter, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruck, TobiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pawlitzki, MarkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Blaes, FranzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kaiser, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schara, UlrikeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Della-Marina, AdelaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thieme, AndreaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hagenacker, TimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jacobi, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berger, BenjaminUNSPECIFIEDorcid.org/0000-0003-2654-2898UNSPECIFIED
Urban, Peter P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Knop, Karl ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schalke, BertholdUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lee, De-HyungUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kalischewski, PetraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wiendl, HeinzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meisel, AndreasUNSPECIFIEDorcid.org/0000-0001-7233-5342UNSPECIFIED
URN: urn:nbn:de:hbz:38-693899
DOI: 10.1007/s00415-022-11389-0
Journal or Publication Title: J. Neurol.
Volume: 270
Number: 1
Page Range: S. 1 - 13
Date: 2023
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1432-1459
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ECULIZUMAB; IMPACTMultiple languages
Clinical NeurologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69389

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