Abstract
The impact of SARS-CoV-2 on pre-existing chronic neuromuscular junction disorders like myasthenia gravis (MG) is not known. We report three patients with pre-existing acetylcholine receptor autoantibody-positive myasthenia gravis who were infected with SARS-CoV-2. We observed the clinical course of these patients during hospitalization, none of the three patients had an exacerbation of peripheral myasthenia syndromes like ptosis, extra-ocular muscle weakness, bulbar or limb weakness during hospitalization. Therapy for MG was not altered during hospitalization for any of the patients. While two of the patients had a favorable outcome, one succumbed to the complications of SARS-CoV-2. Our findings suggest that the clinical course of MG remains unaffected during course, however outcome is variable depending on severity of SARS-CoV-2. Further large observations are needed to define best management and treatment principals and determinants of outcomes in this unique patient population of co-occurrence of SARS-CoV-2 and myasthenia gravis.
Highlights
SARS-CoV-2 infection has caused a global health crisis and apart from respiratory system involvement, it has been found to significantly affect the nervous system- directly or indirectly [1,2,3]
We describe the clinical course and outcomes of three patients with pre-existing myasthenia gravis (MG), infected with SARS-CoV-2
The diagnosis of autoimmune MG was confirmed by reviewing the symptoms, autoantibody status and electrophysiological testing done at the time of receiving the diagnosis
Summary
SARS-CoV-2 infection has caused a global health crisis and apart from respiratory system involvement, it has been found to significantly affect the nervous system- directly or indirectly [1,2,3]. The impact of SARS-CoV-2 on pre-existing chronic neuromuscular junction like myasthenia gravis (MG) is not known. We describe the clinical course and outcomes of three patients with pre-existing MG, infected with SARS-CoV-2
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