Effect of COVID-19 on Myasthenia Gravis (P2-8.006)

Abstract

<h3>Objective:</h3> To describe the effects of COVID-19 on comorbid myasthenia gravis (MG) regarding common symptoms such as limb weakness, oculobulbar weakness, and respiratory failure by evaluating worsening MGFA scores or therapy escalation following COVID-19 infection. <h3>Background:</h3> Myasthenia gravis (MG) is an autoimmune neuromuscular disorder characterized by fluctuating weakness that affects the limbs, oculobulbar muscles, and diaphragm. Therapies include steroids and immunosuppressants, placing patients at high risk of opportunistic infections. Certain triggers can worsen MG, such as medications and infections. We describe the outcomes of 36 patients with confirmed MG and COVID-19, with particular focus on changes in Myasthenia Gravis Foundation of America (MGFA) scores and treatment escalation following infection. <h3>Design/Methods:</h3> Single center retrospective chart review of 36 patients from March 2020-January 2022 with clinically or serologically confirmed MG and COVID-19 <h3>Results:</h3> Of these 36 patients, 20 (55.6%) were not vaccinated against COVID. Twelve patients (33%) had MGFA scores of 3 or 4. Nineteen patients (53%) were prescribed steroids and 18 patients (50%) were on alternate immunotherapy prior to diagnosis of COVID. A total of 5 patients (14%) had a change in baseline MGFA score. One patient’s MGFA score worsened from 1 to 2 and 4 patients required MG treatment escalation. <h3>Conclusions:</h3> Myasthenia gravis patients with higher premorbid MGFA scores, steroid use, or other immunosuppressive therapy would be expected to have worse clinical outcomes in their MG course following COVID infection. Our results indicate 14% of MG patients with COVID had a change from their baseline MGFA score. Our study results revealed higher premorbid MGFA scores or use of immunosuppressant therapy did not alter a patient’s MGFA score following COVID infection. These results are consistent with current literature that COVID infection has little impact on these patients. <b>Disclosure:</b> Dr. Sandhu has nothing to disclose. Dr. Quezada has nothing to disclose. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CSI. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pharmawrite. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Argenx. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for amylyx. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Small has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion.