Department of Neurology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
Huashan Rare Disease Center, Department of Neurology, Huashan Hospital Fudan University, Shanghai, China.
Front Immunol. 2023 May 8;14:1141983. doi: 10.3389/fimmu.2023.1141983. eCollection 2023.
The safety of COVID-19 vaccines has been clarified in clinical trials; however, some immunocompromised patients, such as myasthenia gravis (MG) patients, are still hesitant to receive vaccines. Whether COVID-19 vaccination increases the risk of disease worsening in these patients remains unknown. This study aims to evaluate the risk of disease exacerbation in COVID-19-vaccinated MG patients.
The data in this study were collected from the MG database at Tangdu Hospital, the Fourth Military Medical University, and the Tertiary Referral Diagnostic Center at Huashan Hospital, Fudan University, from 1 April 2022 to 31 October 2022. A self-controlled case series method was applied, and the incidence rate ratios were calculated in the prespecified risk period using conditional Poisson regression.
Inactivated COVID-19 vaccines did not increase the risk of disease exacerbation in MG patients with stable disease status. A few patients experienced transient disease worsening, but the symptoms were mild. It is noted that more attention should be paid to thymoma-related MG, especially within 1 week after COVID-19 vaccination.
COVID-19 vaccination has no long-term impact on MG relapse.
COVID-19 疫苗的安全性已在临床试验中得到证实；然而，一些免疫功能低下的患者，如重症肌无力（MG）患者，仍然对疫苗犹豫不决。COVID-19 疫苗接种是否会增加这些患者疾病恶化的风险尚不清楚。本研究旨在评估 COVID-19 疫苗接种后 MG 患者疾病加重的风险。
本研究的数据来自第四军医大学唐都医院的 MG 数据库和复旦大学华山医院的三级转诊诊断中心，收集时间为 2022 年 4 月 1 日至 2022 年 10 月 31 日。采用自身对照病例系列方法，使用条件泊松回归计算预设风险期内的发病率比。
灭活 COVID-19 疫苗不会增加病情稳定的 MG 患者疾病恶化的风险。少数患者出现短暂的病情加重，但症状较轻。值得注意的是，应更加关注胸腺瘤相关的 MG，特别是在 COVID-19 疫苗接种后 1 周内。
COVID-19 疫苗接种对 MG 复发没有长期影响。
