Impact of Coronavirus Disease 2019 in a French Cohort of Myasthenia Gravis
Impact of Coronavirus Disease 2019 in a French Cohort of Myasthenia Gravis
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DOI：
10.1212/wnl.0000000000011669
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发表时间：
2021-04-20
期刊：
影响因子：
9.9
通讯作者：
Attarian, Shahram
中科院分区：
文献类型：
--
作者：
Sole, Guilhem;Mathis, Stephane;Attarian, Shahram
目的描述重症肌无力(MG)患者并发2019年冠状病毒病(新冠肺炎)的临床特征和转归，并找出与重症肌无力(MG)患者新冠肺炎严重程度相关的因素。新冠肺炎的诊断基于鼻咽拭子或严重急性呼吸综合征冠状病毒2型血清学、胸部CT扫描或典型症状。主要结果是基于治疗/管理地点(家庭、在医疗单元住院或在重症监护病房)的新冠肺炎严重程度。我们收集了有关人口统计学变量、一般病史和严重新冠肺炎的危险因素的信息。结果在法国罕见病数据库中登记的3,558例MG患者中，34例(0.96%)有新冠肺炎。平均发病年龄55.0±19.9岁(平均病程8.5±8.5年)。截至研究结束，28名患者从新冠肺炎康复，1名仍受影响，5名死亡。只有新冠肺炎前的高度重症肌无力美国基金会(MGFA；=IV级)与重度新冠肺炎相关(p=0.004)；与此无关的因素包括性别、MG病程和中等MGFA级(
ObjectiveTo describe the clinical characteristics and outcomes of coronavirus disease 2019 (COVID-19) among patients with myasthenia gravis (MG) and identify factors associated with COVID-19 severity in patients with MG.MethodsThe CO-MY-COVID registry was a multicenter, retrospective, observational cohort study conducted in neuromuscular referral centers and general hospitals of the FILNEMUS (Fili`ere Neuromusculaire) network (between March 1, 2020, and June 8, 2020), including patients with MG with a confirmed or highly suspected diagnosis of COVID-19. COVID-19 was diagnosed based on a PCR test from a nasopharyngeal swab or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serology, thoracic CT scan, or typical symptoms. The main outcome was COVID-19 severity based on location of treatment/management (home, hospitalized in a medical unit, or in an intensive care unit). We collected information on demographic variables, general history, and risk factors for severe COVID-19. Multivariate ordinal regression models were used to identify factors associated with severe COVID-19 outcomes.ResultsAmong 3,558 patients withMGregistered in the French database for rare disorders, 34 (0.96%) had COVID-19. The mean age at COVID-19 onset was 55.0 +/- 19.9 years (mean MG duration: 8.5 +/- 8.5 years). By the end of the study period, 28 patients recovered from COVID-19, 1 remained affected, and 5 died. Only high Myasthenia Gravis Foundation of America (MGFA) class (>= IV) before COVID-19 was associated with severe COVID-19 (p = 0.004); factors that were not associated included sex, MG duration, and medium MGFA classes (