Impact of COVID-19 Infection and Its Association With Previous Vaccination in Patients With Myasthenia Gravis in Korea: A Multicenter Retrospective Study
- 주제(키워드) Myasthenia Gravis , COVID-19 Infection , Vaccination , Outcomes , Worsening
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Han, Hee Jo; Kim, Seung Woo; Shin, Ha Young] Yonsei Univ, Dept Neurol, Coll Med, 50-1 Yonsei Ro, Seoul 03722, South Korea; [Kim, Hyunjin; So, Jungmin; Lee, Eun-Jae; Lim, Young -Min] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Neurol, Seoul, South Korea; [Lee, Jung Hwan] Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Neurol, Seoul, South Korea; [Lee, Myung Ah] Catholic Univ Korea, Uijeongbu St Marys Hosp, Coll Med, Dept Neurol, Seoul, South Korea; [Kim, Byung-Jo; Baek, Seol-Hee] Korea Univ, Anam Hosp, Dept Neurol, Seoul, South Korea; [Lee, Hyung-Soo] Seoul Med Ctr, Dept Neurol, Seoul, South Korea; [Sohn, Eunhee; Kim, Sooyoung] Chungnam Natl Univ, Chungnam Natl Univ Hosp, Coll Med, Dept Neurol, Daejeon, South Korea; [Park, Jin-Sung; Kang, Minsung] Kyungpook Natl Univ, Chilgok Hosp, Sch Med, Dept Neurol, Daegu, South Korea; [Park, Hyung Jun] Yonsei Univ, Coll Med, Gangnam Severance Hosp, Dept Neurol, Seoul, South Korea; [Yoon, Byeol-A; Kim, Jong Kuk] Dong A Univ, Coll Med, Dept Neurol, Pusan, South Korea; [Seok, Hung Youl; Kim, Sohyeon] Keimyung Univ, Sch Med, Dept Neurol, Dongsan Hosp, Daegu, South Korea; [Min, Ju-Hong; Chung, Yeon Hak] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Neurol, Seoul, South Korea; [Cho, Jeong Hee] Natl Hlth Insurance Serv Ilsan Hosp, Dept Neurol, Goyang, South Korea; [Kim, Jee-Eun] Ewha Womans Univ, Coll Med, Dept Neurol, Seoul Hosp, Seoul, South Korea; [Oh, Seong-il] Kyung Hee Univ, Coll Med, Kyung Hee Univ Hosp, Dept Neurol, Seoul, South Korea; [So, Jungmin] Korea Univ, Dept Neurol, Ansan Hosp, Ansan, South Korea
- 등재 SCIE, SCOPUS, KCI등재
- OA유형 Green Published, Gold Open Access
- 발행기관 KOREAN ACAD MEDICAL SCIENCES
- 발행년도 2024
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000240378
- 본문언어 영어
- Published As https://doi.org/10.3346/jkms.2024.39.e150
- PubMed https://pubmed.ncbi.nlm.nih.gov/38742290
초록/요약
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.
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