Kim Sooyoung, Lee Eun Kyoung, Kim Hasung, Kim Hoseob, Sohn Eunhee
Department of Neurology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
Department of Neurology, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Sejong, Republic of Korea.
Front Neurol. 2024 May 6;15:1374370. doi: 10.3389/fneur.2024.1374370. eCollection 2024.
This study investigated the impact of COVID-19 pandemic on the incidence and severity of myasthenia gravis (MG) using the National Health Insurance Service (NHIS) database in Korea.
We analyzed data from patients with MG in the NHIS registry from 2015 to 2021. MG was defined as (1) patients aged ≥18 years with the G70.0 code, and (2) patients who visited tertiary hospitals regarldless of department in Korea (outpatient clinics at least twice or hospitalization at least once), and (3) patients who were prescribed pyridostigmine as MG medications at least once. We designated pre-COVID-19 as 2019 and post-COVID-19 as 2021 and analyzed the MG incidence and prevalence in 2019 and 2021. We compared the clinical data of patients with MG between the two years. MG exacerbation was defined as the administration of intravenous immunoglobulin or plasma exchange. Analysis of COVID-19 cases was conducted using an integrated database from the Korea Disease Control and Prevention Agency and NHIS. Patients with MG were divided into two groups according to COVID-19 status to compare their clinical characteristics.
A total of 6,888 and 7,439 MG cases were identified in 2019 and 2021, respectively. The standardized incidence was 1.56/100,000 in 2019, decreasing to 1.21/100,000 in 2021. Although the frequency of MG exacerbations was higher in 2019, there were no differences in the number and duration of hospitalizations, duration of ICU stays, hostalization expense, and mortality between 2019 and 2021. Patients with MG and COVID-19 had a higher frequency of MG exacerbations than patients without COVID-19, but there were no differences in the number and duration of hospitalizations, hospitalization expense, and mortality.
This study was the first nationwide population-based epidemiological study of MG during COVID-19 pandemic in Korea. The incidence of MG decreased during COVID-19 pandemic, and the severity of MG was not affected by COVID-19.
本研究利用韩国国民健康保险服务（NHIS）数据库，调查了新冠疫情对重症肌无力（MG）发病率和严重程度的影响。
我们分析了2015年至2021年NHIS登记册中MG患者的数据。MG的定义为：（1）年龄≥18岁且编码为G70.0的患者；（2）在韩国三级医院就诊的患者（无论科室，门诊至少两次或住院至少一次）；（3）至少有一次被开具吡啶斯的明作为MG药物的患者。我们将新冠疫情前设定为2019年，新冠疫情后设定为2021年，并分析了2019年和2021年MG的发病率和患病率。我们比较了这两年MG患者的临床数据。MG病情加重定义为静脉注射免疫球蛋白或进行血浆置换。利用韩国疾病控制与预防机构和NHIS的综合数据库对新冠病例进行分析。根据新冠感染状况将MG患者分为两组，以比较其临床特征。
2019年和2021年分别共识别出6888例和7439例MG病例。2019年的标准化发病率为1.56/10万，2021年降至1.21/10万。尽管2019年MG病情加重的频率较高，但2019年和2021年在住院次数和时长、重症监护病房停留时长、住院费用及死亡率方面并无差异。感染新冠的MG患者比未感染新冠的患者MG病情加重的频率更高，但在住院次数和时长、住院费用及死亡率方面并无差异。
本研究是韩国首次在全国范围内基于人群的新冠疫情期间MG流行病学研究。新冠疫情期间MG发病率下降，且MG的严重程度不受新冠影响。
