{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T03:43:01Z","timestamp":1785555781453,"version":"3.56.0"},"reference-count":18,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>There are limited data regarding COVID-19 outcomes and vaccine uptake and safety among people with myasthenia gravis (MG).<\/jats:p><\/jats:sec>Objective<\/jats:title>To investigate COVID-19\u2013related outcomes and vaccine uptake among a population-based sample of adults with MG.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This population-based, matched cohort study in Ontario, Canada, used administrative health data from January 15, 2020, and August 31, 2021. Adults with MG were identified using a validated algorithm. Each patient was matched by age, sex, and geographic area of residence to 5 controls from the general population and from a cohort of individuals with rheumatoid arthritis (RA).<\/jats:p><\/jats:sec>Exposure<\/jats:title>Patients with MG and matched controls.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Main outcomes were COVID-19 infection and related hospitalizations, intensive care unit admissions, and 30-day mortality among patients with MG vs controls. Secondary outcomes were uptake of COVID-19 vaccination among patients with MG vs controls.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 11\u202f365\u202f233 eligible Ontario residents, 4411 patients with MG (mean [SD] age, 67.7 [15.6] years; 2274 women [51.6%]) were matched to 22\u202f055 general population controls (mean [SD] age, 67.7 [15.6] years; 11\u202f370 women [51.6%]) and 22\u202f055 controls with RA (mean [SD] age, 67.7 [15.6] years; 11\u202f370 women [51.6%]). In the matched cohort, 38\u202f861 of 44\u202f110 individuals (88.1%) were urban residents; in the MG cohort, 3901 (88.4%) were urban residents. Between January 15, 2020, and May 17, 2021, 164 patients with MG (3.7%), 669 general population controls (3.0%), and 668 controls with RA (3.0%) contracted COVID-19. Compared with general population controls and controls with RA, patients with MG had higher rates of COVID-19\u2013associated emergency department visits (36.6% [60 of 164] vs 24.4% [163 of 669] vs 29.9% [200 of 668]), hospital admissions (30.5% [50 of 164] vs 15.1% [101 of 669] vs 20.7% [138 of 668]), and 30-day mortality (14.6% [24 of 164] vs 8.5% [57 of 669] vs 9.9% [66 of 668]). By August 2021, 3540 patients with MG (80.3%) vs 17\u202f913 general population controls (81.2%) had received 2 COVID-19 vaccine doses, and 137 (3.1%) vs 628 (2.8%), respectively had received 1 dose. Of 3461 first vaccine doses for patients with MG, fewer than 6 individuals were hospitalized for MG worsening within 30 days of vaccination. Vaccinated patients with MG had a lower risk than unvaccinated patients with MG of contracting COVID-19 (hazard ratio, 0.43; 95% CI, 0.30-0.60).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>This study suggests that adults with MG who contracted COVID-19 had a higher risk of hospitalization and death compared with matched controls. Vaccine uptake was high, with negligible risk of severe MG exacerbations after vaccination, as well as evidence of effectiveness. The findings support public health policies prioritizing people with MG for vaccination and new COVID-19 therapeutics.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.9834","type":"journal-article","created":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T15:40:43Z","timestamp":1682437243000},"page":"e239834","source":"Crossref","is-referenced-by-count":21,"title":["Outcomes of COVID-19 Infection and Vaccination Among Individuals With Myasthenia Gravis"],"prefix":"10.1001","volume":"6","author":[{"given":"Monica","family":"Alcantara","sequence":"first","affiliation":[{"name":"Ellen & Martin Prosserman Centre for Neuromuscular Diseases, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Koh","sequence":"additional","affiliation":[{"name":"ICES, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison 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