Impact of COVID-19 Infection and Its Association With Previous Vaccination in Patients With Myasthenia Gravis in Korea: A Multicenter Retrospective Study
10.3346/jkms.2024.39.e150
- Author:
Hee Jo HAN
1
;
Seung Woo KIM
;
Hyunjin KIM
;
Jungmin SO
;
Eun-Jae LEE
;
Young-Min LIM
;
Jung Hwan LEE
;
Myung Ah LEE
;
Byung-Jo KIM
;
Seol-Hee BAEK
;
Hyung-Soo LEE
;
Eunhee SOHN
;
Sooyoung KIM
;
Jin-Sung PARK
;
Minsung KANG
;
Hyung Jun PARK
;
Byeol-A YOON
;
Jong Kuk KIM
;
Hung Youl SEOK
;
Sohyeon KIM
;
Ju-Hong MIN
;
Yeon Hak CHUNG
;
Jeong Hee CHO
;
Jee-Eun KIM
;
Seong-il OH
;
Ha Young SHIN
Author Information
1. Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
- Publication Type:Original Article
- From:Journal of Korean Medical Science
2024;39(18):e150-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:During the coronavirus disease 2019 (COVID-19) pandemic, patients with myasthenia gravis (MG) were more susceptible to poor outcomes owing to respiratory muscle weakness and immunotherapy. Several studies conducted in the early stages of the COVID-19 pandemic reported higher mortality in patients with MG compared to the general population. This study aimed to investigate the clinical course and prognosis of COVID-19 in patients with MG and to compare these parameters between vaccinated and unvaccinated patients in South Korea.
Methods:This multicenter, retrospective study, which was conducted at 14 tertiary hospitals in South Korea, reviewed the medical records and identified MG patients who contracted COVID-19 between February 2022 and April 2022. The demographic and clinical characteristics associated with MG and vaccination status were collected. The clinical outcomes of COVID-19 infection and MG were investigated and compared between the vaccinated and unvaccinated patients.
Results:Ninety-two patients with MG contracted COVID-19 during the study. Nine (9.8%) patients required hospitalization, 4 (4.3%) of whom were admitted to the intensive care unit. Seventy-five of 92 patients were vaccinated before contracting COVID-19 infection, and 17 were not. During the COVID-19 infection, 6 of 17 (35.3%) unvaccinated patients were hospitalized, whereas 3 of 75 (4.0%) vaccinated patients were hospitalized (P < 0.001). The frequencies of ICU admission and mechanical ventilation were significantly lower in the vaccinated patients than in the unvaccinated patients (P = 0.019 and P = 0.032, respectively). The rate of MG deterioration was significantly lower in the vaccinated patients than in the unvaccinated patients (P = 0.041). Logistic regression after weighting revealed that the risk of hospitalization and MG deterioration after COVID-19 infection was significantly lower in the vaccinated patients than in the unvaccinated patients.
Conclusion:This study suggests that the clinical course and prognosis of patients with MG who contracted COVID-19 during the dominance of the omicron variant of COVID-19 may be milder than those at the early phase of the COVID-19 pandemic when vaccination was unavailable. Vaccination may reduce the morbidity of COVID-19 in patients with MG and effectively prevent MG deterioration induced by COVID-19 infection.
