Abstract Details

Title Retrospective Cohort Study Evaluating Outcomes in Myasthenia Gravis Patients with COVID-19

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 11-002

Objective We evaluated clinical outcomes of myasthenia gravis (MG) patients with COVID-19 infection to determine factors associated with poor outcomes.

Background MG is an autoimmune disease affecting the neuromuscular junction. MG patients often manifest dyspnea and dysphagia and have an increased risk of infection due to immunosuppressants use, which may compound the severity of COVID-19 symptoms. A comprehensive understanding of clinical outcomes of MG-COVID patients is crucial in clinical decision making.

Design/Methods We conducted a retrospective cohort study using the Optum® de-identified COVID-19 Electronic Health Record (EHR) data. Primary outcomes include death, hospitalization, intubation, and ICU stay. We analyzed factors that may affect the outcomes such as age, sex, ethnicity, geographic region, month of COVID-19 diagnosis, comorbidities, and MG-specific treatments. Then, we compared these outcomes with non-MG COVID as well as rheumatoid arthritis (RA), systemic lupus (SLE) and multiple sclerosis (MS) with COVID-19 using a modified multivariable Poisson regression model.

Results Our study includes total of 421,086 individuals with COVID-19 among which 377 were MG-COVID. MG was not associated with increased risk of ventilator use or death but was associated with increased risk of hospitalization (aRR=1.28, 95% CI 1.13-1.46, p <0.001) and ICU stay (aRR=1.51, 95% CI 1.16-1.96, p=0.002) when accounting for the covariates in COVID-19. The mortality of the MG-COVID subgroup was 10%, and it was associated with age 75 or older (aRR=9.57, 95% CI 1.56-58.76, p=0.015) and presence of dysphagia (aRR=1.84, 95% CI 1.06-3.21, p=0.031) but not immunosuppressants use. The MG-COVID had higher adjusted risks of hospitalization and ICU admission compared to the RA-COVID but similar to the SLE- and MS-COVID subgroups.

Conclusions Our study provides insight into how COVID-19 infection affected MG patients. Neurologists may consider these outcomes when providing MG with COVID-19 patients and their families with treatment options, vaccination counseling, and prognosis.

Authors/Disclosures
Minseon Kim, MD (University of Colorado) PRESENTER	Dr. Kim has nothing to disclose.
Youngran Kim	Ms. Kim has nothing to disclose.
	No disclosure on file
	No disclosure on file
Aziz I. Shaibani, MD, FAAN (Houston Neurocare, PA)	Dr. Shaibani has nothing to disclose.
Thy Nguyen, MD (University of Texas Health Science Center)	Dr. Nguyen has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for ArgenX. Dr. Nguyen has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for UCB. Dr. Nguyen has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion. Dr. Nguyen has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Takeda. Dr. Nguyen has received publishing royalties from a publication relating to health care.

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