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01-06-2021 | Myasthenia Gravis | Review article

Myasthenia gravis at the crossroad of COVID-19: focus on immunological and respiratory interplay

Authors: Giuliana Galassi, Alessandro Marchioni

Published in: Acta Neurologica Belgica | Issue 3/2021

Abstract

Coronavirus disease 2019 (COVID-19), a disease caused by the novel betacoronavirus (SARS-CoV-2) has become a global pandemic threat. COVID-19 caused by SARS-CoV-2 is reported to originate in December 2019 in Wuhan, China and spreading rapidly around world. SARS-CoV-2 is structurally similar to the other coronaviruses, causing the severe respiratory syndrome (SARS-CoV) and the middle east respiratory syndrome (MERS-CoV), both binding to the angiotensin-converting enzyme 2 (ACE2) receptor to enter human cells. ACE 2 is widely expressed in several cells including, neural tissue. COVID-19 presents with fever and respiratory symptoms, possibly leading to acute respiratory distress (ARDS) but there are several published reports of acute cerebrovascular diseases, seizures, olfactory and gustatory dysfunctions, isolated involvement of cranial nerves, myositis/rabdhomyolisis as well myasthenic crisis (MC) and Guillain–Barré syndrome (GBS). The ARDS described during COVID-19 pandemic, coupled with respiratory muscle failure occurring in myasthenia gravis (MG), may result in a life-threatening condition, challenging for intensivists, pulmonologists and neurologists. Infections are recognized trigger of exacerbations and crisis in MG and patients with MG probably exhibit a mortality higher than the general population during this COVID-19 pandemic. We review the current state of knowledge on MG during the COVID-19 pandemic to focus the immunological and respiratory interplay between these two conditions.

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Title: Myasthenia gravis at the crossroad of COVID-19: focus on immunological and respiratory interplay
Authors: Giuliana Galassi
Alessandro Marchioni
Publication date: 01-06-2021
Publisher: Springer International Publishing
Keywords: Myasthenia Gravis
SARS-CoV-2
Acute Respiratory Distress-Syndrome
COVID-19
Non-Invasive Ventilation
Published in: Acta Neurologica Belgica / Issue 3/2021
Print ISSN: 0300-9009
Electronic ISSN: 2240-2993
DOI: https://doi.org/10.1007/s13760-021-01612-6

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Myasthenia gravis at the crossroad of COVID-19: focus on immunological and respiratory interplay

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