• Hee Jo Han, 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, and Ha Young Shin.
• Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
• J. Korean Med. Sci. 2024 May 13; 39 (18): e150e150.

BackgroundDuring 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.MethodsThis 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.ResultsNinety-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.ConclusionThis 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.© 2024 The Korean Academy of Medical Sciences.

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