{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T22:46:04Z","timestamp":1776811564102,"version":"3.51.2"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,2,9]],"date-time":"2022-02-09T00:00:00Z","timestamp":1644364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Coronavirus disease\u20102019 (COVID\u201019) may have a more severe course in patients with myasthenia gravis (MG). We aimed to assess severity of the infection and factors contributing to its severity in a group of MG patients, most of whom were not hospitalized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred forty outpatients with MG followed between March 2020 and April 2021 were included in our study. Patients were asked to respond to a brief questionnaire in person, by telemedicine, or through electronic messages.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nineteen patients tested positive for COVID\u201019 by polymerase chain reaction. Two were asymptomatic. Of the 17 symptomatic patients, 11 had mild symptoms. They either had no treatment or received antivirals, antibiotics, and anticoagulants. Their myasthenia was well\u2010controlled before infection and was unaffected by COVID\u201019. Three patients with moderate COVID\u201019 required hospitalization, but not intensive care, and had full recovery. Three other patients, the oldest in the cohort, had severe disease: One patient with a postsurgery myasthenic exacerbation before the infection needed intensive care without intubation, but recovered completely; two morbidly obese patients with comorbidities required intubation and died. Corticosteroids were increased in four of the six moderate\/severely affected patients. Immunosuppressive (IS) agents were generally continued. Hydroxychloroquine (HCQ) for COVID\u201019 was used in one patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Most patients had mild COVID\u201019 and all but two patients recovered. The design of the study made it possible to capture mild cases. Having well\u2010controlled MG before infection and absence of comorbidities likely affected the course of the infection favorably. IS did not influence the progression.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.27497","type":"journal-article","created":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T06:20:29Z","timestamp":1642486829000},"page":"447-452","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Clinical course and outcome of an outpatient clinic population with myasthenia gravis and <scp>COVID<\/scp>\u201019"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7186-2175","authenticated-orcid":false,"given":"Ozlem","family":"Gungor Tuncer","sequence":"first","affiliation":[{"name":"Department of Neurology Memorial Sisli Hospital  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feza","family":"Deymeer","sequence":"additional","affiliation":[{"name":"Department of Neurology Memorial Sisli Hospital  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,2,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000009566"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-018-8751-9"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30413-0"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2020.04.004"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.01053"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ane.13440"},{"key":"e_1_2_9_8_1","first-page":"1","article-title":"Case series of COVID\u201019 in patients with myasthenia gravis: a single institution experience","volume":"1","author":"\u017dupani\u0107 S","year":"2021","journal-title":"Acta Neurol Belg"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26918"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2020-323565"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2020.117053"},{"key":"e_1_2_9_12_1","first-page":"100332","article-title":"Case series: COVID\u201019 in patients with mild to moderate myasthenia gravis in a national referral hospital in Indonesia","volume":"23","author":"Octaviana F","year":"2021","journal-title":"eNeurol Sci"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2524"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-021-10428-6"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2020.106045"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27020"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3233\/JND-200520"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2020.110001"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2020.116888"},{"key":"e_1_2_9_20_1","first-page":"8845844","article-title":"COVID\u201019 presentation in association with myasthenia gravis: a case report and review of the literature","volume":"2020","author":"Aksoy E","year":"2020","journal-title":"Case Rep Infect Dis"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.5811\/cpcem.2020.9.49049"},{"issue":"55","key":"e_1_2_9_22_1","first-page":"16","article-title":"Myasthenia gravis: recommendations for clinical research standards. Task force of the medical scientific advisory board of the Myasthenia Gravis Foundation of America","volume":"12","author":"Jaretzki A","year":"2000","journal-title":"Neurology"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21533"},{"key":"e_1_2_9_24_1","first-page":"CD013587","article-title":"Chloroquine or hydroxychloroquine for prevention and treatment of COVID\u201019","volume":"2","author":"Singh B","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-011-6335-z"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.17022"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa601"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30628-0"}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.27497","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mus.27497","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.27497","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T09:39:00Z","timestamp":1692437940000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.27497"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,9]]},"references-count":27,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1002\/mus.27497"],"URL":"https:\/\/doi.org\/10.1002\/mus.27497","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,9]]},"assertion":[{"value":"2021-08-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}