• Netaniel Rein, Nitzan Haham, Efrat Orenbuch-Harroch, Marc Romain, Zohar Argov, Adi Vaknin-Dembinsky, and Marc Gotkine.
• Hadassah-Hebrew University Medical Center, Department of Neurology, the Agnes-Ginges Center for Neurogenetics Jerusalem, Israel. Electronic address: Netaniel.rein@mail.huji.ac.il.
• J. Neurol. Sci. 2020 Oct 15; 417: 117053.

BackgroundThe COVID-19 pandemic presents two main concerns for patients with myasthenia gravis (MG); chronic immunosuppression may put them at greater risk, and some proposed treatments for COVID-19 could cause MG exacerbation.Case DescriptionWe present three patients with generalized seropositive MG who developed COVID-19. All patients had a favorable outcome, with only one patient experiencing exacerbation. In this case, exacerbation began before COVID-19; she required ICU admission, non-invasive ventilatory support, and received hydroxychloroquine, lopinavir and ritonavir which were well tolerated. One patient received IVIG in place of scheduled plasma exchange.ConclusionOutcome was favorable in all cases despite immunosuppressive therapy, use of experimental COVID-19 medication and switching of plasma exchange for IVIG.Copyright © 2020 Elsevier B.V. All rights reserved.

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