University of Belgrade-Faculty of Medicine, University Clinical Center of Serbia-Neurology Clinic, Belgrade, Serbia.
University Clinical Centre of Serbia - Neurology Clinic, Dr Subotic Street 6, 11000, Belgrade, Serbia.
Acta Neurol Belg. 2023 Apr;123(2):529-536. doi: 10.1007/s13760-022-02121-w. Epub 2022 Oct 24.
Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction which is typically presented with muscle weakness and excessive fatigability. Majority of MG patients require long-term immune suppression. Our aim was to analyze the frequency and severity of COVID-19 infection in MG patients, as well as the frequency of vaccinated MG patients against SARS-CoV-2.
We included 125 MG patients from the central Belgrade municipalities-60% females, age at MG onset 50.1 ± 19.7 years, age at testing 61.7 ± 16.8 years, anti-acetylcholine receptor (anti-AChR) positive 78% and muscle specific tyrosine kinase (MuSK) positive 8.6%.
One-third of our MG patients had a COVID-19 infection and they were younger compared to those without verified COVID-19. Severe COVID-19 infection was registered in 28% of MG patients, mostly in elder subjects with comorbidities such as cardiac diseases and malignancies. MG worsening was noted in 21% of patients during/after COVID-19 and 42% had COVID-19 sequelae. Majority of MG patients were vaccinated against SARS-CoV-2 (almost 70%). Vaccination was more common among MG patients with diabetes and in those with a milder form of MG. The most common types of vaccines were Sinopharm (42%) and Pfizer-BioNTech (25.6%). Adverse events were observed in 36% of vaccinated patients, with flu-like symptoms (77%) and local reactions (13%) being the most common ones. MG worsening was noticed in 5 (5.8%) patients after vaccination.
COVID-19 has placed a significant new burden for MG patients. Elder MG patients and patients with comorbidities are in higher risk of having adverse outcome following SARS-CoV-2 infection. Percentage of vaccinated MG patients was higher than in general Serbian population.
重症肌无力（MG）是一种影响神经肌肉接头的自身免疫性疾病，其特征通常为肌肉无力和过度疲劳。大多数 MG 患者需要长期免疫抑制。我们的目的是分析 MG 患者 COVID-19 感染的频率和严重程度，以及接种 SARS-CoV-2 疫苗的 MG 患者的频率。
我们纳入了来自贝尔格莱德市中心城区的 125 名 MG 患者-60%为女性，MG 发病年龄为 50.1±19.7 岁，检测时年龄为 61.7±16.8 岁，抗乙酰胆碱受体（anti-AChR）阳性率为 78%，肌肉特异性酪氨酸激酶（MuSK）阳性率为 8.6%。
我们三分之一的 MG 患者感染了 COVID-19，且与未确诊 COVID-19 的患者相比，他们更年轻。MG 患者中有 28%发生了严重 COVID-19 感染，主要发生在患有心脏病和恶性肿瘤等合并症的老年患者中。MG 恶化在 COVID-19 期间/之后在 21%的患者中被注意到，42%的患者有 COVID-19 后遗症。大多数 MG 患者接种了 SARS-CoV-2 疫苗（近 70%）。MG 患者中患有糖尿病和病情较轻的患者接种疫苗更为常见。最常见的疫苗类型是国药（42%）和辉瑞-生物科技（25.6%）。在接种疫苗的患者中，有 36%观察到不良反应，最常见的是流感样症状（77%）和局部反应（13%）。接种疫苗后，有 5 名（5.8%）患者出现 MG 恶化。
COVID-19 给 MG 患者带来了新的重大负担。老年 MG 患者和合并症患者在感染 SARS-CoV-2 后发生不良后果的风险更高。接种 MG 患者的比例高于塞尔维亚一般人群。
