Department of Neurology, Boston University Medical Center, Boston, Massachusetts.
Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts.
Muscle Nerve. 2020 Aug;62(2):254-258. doi: 10.1002/mus.26918. Epub 2020 May 22.
Coronavirus disease 2019 (COVID-19) has rapidly become a global pandemic, but little is known about its potential impact on patients with myasthenia gravis (MG).
We studied the clinical course of COVID-19 in five hospitalized patients with autoimmune MG (four with acetylcholine receptor antibodies, one with muscle-specific tyrosine kinase antibodies) between April 1, 2020-April 30-2020.
Two patients required intubation for hypoxemic respiratory failure, whereas one required significant supplemental oxygen. One patient with previously stable MG had myasthenic exacerbation. One patient treated with tocilizumab for COVID-19 was successfully extubated. Two patients were treated for MG with intravenous immunoglobulin without thromboembolic complications.
Our findings suggest that the clinical course and outcomes in patients with MG and COVID-19 are highly variable. Further large studies are needed to define best practices and determinants of outcomes in this unique population.
2019 年冠状病毒病（COVID-19）迅速成为一种全球性大流行病，但人们对其对重症肌无力（MG）患者的潜在影响知之甚少。
我们研究了 2020 年 4 月 1 日至 4 月 30 日期间五例住院自身免疫性 MG 患者（四例乙酰胆碱受体抗体阳性，一例肌肉特异性酪氨酸激酶抗体阳性）COVID-19 的临床过程。
两名患者因低氧性呼吸衰竭需要插管，而一名患者需要大量补充氧气。一名先前病情稳定的 MG 患者出现肌无力危象。一名接受托珠单抗治疗 COVID-19 的患者成功拔管。两名患者因 COVID-19 接受静脉注射免疫球蛋白治疗，无血栓并发症。
我们的研究结果表明，MG 和 COVID-19 患者的临床过程和结局高度可变。需要进一步的大型研究来确定这一特殊人群的最佳治疗方法和结局决定因素。
