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Published in: BMC Neurology 1/2022

Open Access 01-12-2022 | Myasthenia Gravis | Research

Impact of COVID-19 infection among myasthenia gravis patients- a Cerner Real-World DataTM study

Authors: Lakshmi Prasanna Digala, Shivika Prasanna, Praveen Rao, Adnan I. Qureshi, Raghav Govindarajan

Published in: BMC Neurology | Issue 1/2022

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Abstract

Background

Myasthenia gravis (MG) is an auto-immune disease, and the mainstay of therapy is immunomodulation. Such patients are at high risk of acquiring any infections. Hence, we sought to determine the impact of the current global pandemic COVID-19 infection in MG patients.

Methods

For our study, we used Cerner Real-World DataTM that was provided through Cerner’s HealtheDataLab research tool. We ran a database query from January 2019 to July 2020 in our study and identified myasthenia patients with and without COVID-19 infection. To extract these patients’ data, we used ICD 9-CM, ICD-10, and SNOMED-CT codes. We reported the data using means, range, and prevalence rates, and the p-values were calculated using the two-sample t-test and Pearson’s chi-squared test.

Results

In the COVID-19 data set, a total of twenty-seven myasthenia patients were identified with a positive COVID-19 infection, and four were diagnosed with an exacerbation. The male to female ratio was equal and one unknown gender (3.7%) with a mean (± SD) age of 64.33 ± 18.42 years. This study group was compared with a non-COVID-19 data set in which a total of sixty-four myasthenia patients were identified, and twenty-three had an exacerbation. Among the 13 hospitalized patients in the two groups, the mean length of hospitalization for the myasthenia patients in the COVID-19 data set was 8.28 days (n = 7), and the non-COVID-19 set was 4.33 days (n = 6), and it was statistically significant (p-value= 0.007).

Conclusions

The mean length of hospital stay is prolonged in myasthenia patients who tested positive for COVID-19.
Literature
1.
go back to reference Sieb JP. Myasthenia gravis: an update for the clinician. Clin Exp Immunol. 2014;175(3):408–18.CrossRef Sieb JP. Myasthenia gravis: an update for the clinician. Clin Exp Immunol. 2014;175(3):408–18.CrossRef
2.
go back to reference Ropper AH, Gress DR, Diringer MN, et al. Treatment of the Critically Ill Patient With Myasthenia Gravis. In: Neurological and Neurosurgical Intensive Care. 4th ed. Philadelphia: Lipincott Williams & Wilkins; 2004. p. 299–311. Ropper AH, Gress DR, Diringer MN, et al. Treatment of the Critically Ill Patient With Myasthenia Gravis. In: Neurological and Neurosurgical Intensive Care. 4th ed. Philadelphia: Lipincott Williams & Wilkins; 2004. p. 299–311.
3.
go back to reference Wendell LC, Levine JM. Myasthenic crisis. Neurohospitalist. 2011;1(1):16–22.CrossRef Wendell LC, Levine JM. Myasthenic crisis. Neurohospitalist. 2011;1(1):16–22.CrossRef
4.
go back to reference Lotfi M, Hamblin MR, Rezaei N. COVID-19: Transmission, prevention, and potential therapeutic opportunities. Clinica Chimica Acta. 2020 May 29. Lotfi M, Hamblin MR, Rezaei N. COVID-19: Transmission, prevention, and potential therapeutic opportunities. Clinica Chimica Acta. 2020 May 29.
6.
go back to reference Muppidi S, Guptill JT, Jacob S, et al. COVID-19-associated risks and effects in myasthenia gravis (CARE-MG). Lancet Neurol. 2020;19(12):970–1.CrossRef Muppidi S, Guptill JT, Jacob S, et al. COVID-19-associated risks and effects in myasthenia gravis (CARE-MG). Lancet Neurol. 2020;19(12):970–1.CrossRef
7.
go back to reference Delly F, Syed MJ, Lisak RP, Zutshi D. Myasthenic crisis in COVID-19. J. Neurol. Sci. 2020; 414:116888. Delly F, Syed MJ, Lisak RP, Zutshi D. Myasthenic crisis in COVID-19. J. Neurol. Sci. 2020; 414:116888.
8.
go back to reference Ramaswamy SB, Govindarajan R. COVID-19 in Refractory Myasthenia Gravis-A Case Report of Successful Outcome. J. Neuromuscul. Dis. 2020 May 30(Preprint):1–4. Ramaswamy SB, Govindarajan R. COVID-19 in Refractory Myasthenia Gravis-A Case Report of Successful Outcome. J. Neuromuscul. Dis. 2020 May 30(Preprint):1–4.
9.
go back to reference Anand P, Slama MC, Kaku M, et al. COVID-19 in patients with myasthenia gravis. Muscle Nerve. 2020;62(2):254–8. Anand P, Slama MC, Kaku M, et al. COVID-19 in patients with myasthenia gravis. Muscle Nerve. 2020;62(2):254–8.
10.
go back to reference Camelo-Filho AE, Silva A, Estephan EP, et al. Myasthenia gravis and COVID-19: clinical characteristics and outcomes. Front Neurol. 2020;11:1053.CrossRef Camelo-Filho AE, Silva A, Estephan EP, et al. Myasthenia gravis and COVID-19: clinical characteristics and outcomes. Front Neurol. 2020;11:1053.CrossRef
11.
go back to reference Yang J, Zheng Y, Gou X, et al., Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis. 2020; 94: 91–95. Yang J, Zheng Y, Gou X, et al., Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis. 2020; 94: 91–95.
12.
go back to reference Guan WJ, Liang WH, Zhao Y, et al. Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis. Eur Respir J. 2020;55(5):2000547.CrossRef Guan WJ, Liang WH, Zhao Y, et al. Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis. Eur Respir J. 2020;55(5):2000547.CrossRef
13.
go back to reference Jacob S, Muppidi S, Guidon A, et al. Guidance for the management of myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) during the COVID-19 pandemic. J. Neurol. Sci. 2020;412:116803. Jacob S, Muppidi S, Guidon A, et al. Guidance for the management of myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) during the COVID-19 pandemic. J. Neurol. Sci. 2020;412:116803.
14.
go back to reference Gummi RR, Kukulka NA, Deroche CB, et al., Factors associated with acute exacerbations of myasthenia gravis. Muscle and Nerve. 2019; 60:693–699.CrossRef Gummi RR, Kukulka NA, Deroche CB, et al., Factors associated with acute exacerbations of myasthenia gravis. Muscle and Nerve. 2019; 60:693–699.CrossRef
15.
go back to reference Jani-Acsadi A, Lisak RP. Myasthenic crisis: guidelines for prevention and treatment. J. Neurol. Sci. 2007;261(1-2):127–33. Jani-Acsadi A, Lisak RP. Myasthenic crisis: guidelines for prevention and treatment. J. Neurol. Sci. 2007;261(1-2):127–33.
16.
go back to reference Sipilä JO, Soilu-Hänninen M, Rautava P, et al., Hospital admission and prevalence trends of adult myasthenia gravis in Finland in 2004–2014: A retrospective national registry study. J. Neurol. Sci. 2019; 407:116520. Sipilä JO, Soilu-Hänninen M, Rautava P, et al., Hospital admission and prevalence trends of adult myasthenia gravis in Finland in 2004–2014: A retrospective national registry study. J. Neurol. Sci. 2019; 407:116520.
Metadata
Title
Impact of COVID-19 infection among myasthenia gravis patients- a Cerner Real-World DataTM study
Authors
Lakshmi Prasanna Digala
Shivika Prasanna
Praveen Rao
Adnan I. Qureshi
Raghav Govindarajan
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2022
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-022-02564-x

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