Öcek Levent, Özen Tuğba Demir, Öcek Özge, Sarıteke Alp, Şener Ufuk
University of Healthy Sciences, Tepecik Education and Research Hospital, Department of Neurology, İzmir, Turkey.
University of Healthy Sciences, İzmir Faculty of Medicine, Department of Neurology, İzmir, Turkey.
Noro Psikiyatr Ars. 2024 Aug 19;67(3):213-220. doi: 10.29399/npa.28418. eCollection 2024.
In this study, we aimed to investigate the clinical effects of COVID-19 infection and vaccines on Myasthenia gravis (MG) during the pandemic.
A total of 141 MG patients between April 2020 and December 2021 were retrospectively analyzed. Data including demographic and clinical characteristics of patients, COVID-19 test results, and vaccine types (mRNA-BNT162b2 and/or inactivated-CoronaVac) were recorded. All patients were followed by face-to-face interviews and/or phone calls. Worsening MG symptoms after COVID-19 infection or vaccines were noted.
A total of 60 patients were diagnosed with COVID-19, and reverse transcriptase-polymerase chain reaction test results were COVID-19 positive in 54 (90%) patients. Twenty-eight (46.7%) patients had lung involvement, while 20(33.3%) patients were followed in the ward. Twelve (20%) patients were followed in the intensive care unit, and two of them (3.3%) died. Both deceased patients were unvaccinated. The most common symptoms were fatigue (78.3%), and 13(21.7%) patients were asymptomatic. Of the patients, 96(68%) received at least one dose BNT162b2 or CoronaVac, while 30.4% of the patients received ≥3 doses of vaccines. The local skin irritation and fatigue rate was significantly higher with BNT162b2 vaccine than CoronaVac (p<0.001 and p=0.004, respectively). No serious side effect was observed with either vaccine. Five patients had worsening MG symptoms after vaccination during a six-week follow-up. None of the patients experienced myasthenic crises.
Our study results suggest that COVID-19 infection affects MG similar to the general population and does not lead to worsening MG symptoms. Both mRNA and inactivated vaccines with proven efficacy can be used safely in MG patients.
在本研究中，我们旨在调查大流行期间新型冠状病毒肺炎（COVID-19）感染和疫苗对重症肌无力（MG）的临床影响。
回顾性分析了2020年4月至2021年12月期间的141例MG患者。记录了患者的人口统计学和临床特征、COVID-19检测结果以及疫苗类型（信使核糖核酸-BNT162b2和/或灭活疫苗-科兴新冠疫苗）等数据。所有患者均通过面对面访谈和/或电话进行随访。记录COVID-19感染或接种疫苗后MG症状的恶化情况。
共有60例患者被诊断为COVID-19，其中54例（90%）患者的逆转录聚合酶链反应检测结果为COVID-19阳性。28例（46.7%）患者有肺部受累，20例（33.3%）患者在病房接受随访。12例（20%）患者在重症监护病房接受随访，其中2例（3.3%）死亡。两名死亡患者均未接种疫苗。最常见的症状是疲劳（78.3%），13例（21.7%）患者无症状。在这些患者中，96例（68%）接受了至少一剂BNT162b2或科兴新冠疫苗，而30.4%的患者接受了≥3剂疫苗。BNT162b2疫苗引起的局部皮肤刺激和疲劳发生率显著高于科兴新冠疫苗（分别为p<0.001和p=0.004）。两种疫苗均未观察到严重副作用。在六周的随访期间，有5例患者在接种疫苗后MG症状恶化。没有患者发生重症肌无力危象。
我们的研究结果表明，COVID-19感染对MG的影响与普通人群相似，不会导致MG症状恶化。已证实有效的信使核糖核酸疫苗和灭活疫苗均可在MG患者中安全使用。
