{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:05:10Z","timestamp":1753891510533,"version":"3.41.2"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>There are indeed several studies addressing the severity of Coronavirus disease 2019 (COVID-19) infection in myasthenia gravis (MG) patients. However, data on post-COVID-19 sequelae in MG patients remain limited. To address this gap, we collected clinical data on the condition and prognosis of MG patients with COVID-19 infection, aiming to investigate factors influencing both the severity of the infection and the occurrence of post-COVID-19 sequelae at 1 and 12 months after recovery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This was a retrospective analysis of 150 MG patients with COVID-19 infection from November 1, 2022 to March 1, 2023 at the First Affiliated Hospital of Guangzhou University of Chinese Medicine, including patient demographics, clinical characteristics, and post-COVID-19 sequelae. Multivariable binary logistic and linear regression models were employed to ascertain the variables influencing the severity. The evolution of the post-COVID-19 sequelae was analyzed using McNemar's test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>In 150 MG patients, 128 (85.3%) patients were presented with COVID-19 infection, and 23 (18%) patients were hospitalized. The severity was associated with the daily corticosteroid dose (OR = 1.08, <jats:italic>p<\/jats:italic> = 0.02) and the frequency of myasthenia crises pre-COVID-19 (<jats:italic>b<\/jats:italic> = 7.8, <jats:italic>t<\/jats:italic> = 2.14, <jats:italic>p<\/jats:italic> = 0.035). Compared to normal patients, MG patients are more likely to experience post-COVID-19 sequelae such as insomnia, myalgia, dizziness, cough, expectoration, and sore throat at 12 months after recovery. Among these, the prevalence of myalgia, dizziness, rash, and vision impairment was significantly higher.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared to normal patients, MG patients are prone to developing severe COVID-19 infection, which is associated with the daily corticosteroid dose and the frequency of myasthenia crises pre-COVID-19. Additionally, they are prone to experiencing post-COVID-19 sequelae, including insomnia, myalgia, dizziness, cough, expectoration, and sore throat, at 12 months after recovery.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1513649","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T06:48:34Z","timestamp":1743576514000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The clinical risk and post-COVID-19 sequelae in patients with myasthenia gravis: a retrospective observational study"],"prefix":"10.3389","volume":"16","author":[{"given":"Chaoyue","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haocheng","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yufei","family":"Deng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongjin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiang","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiaxin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linqi","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaojun","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qilong","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1002\/jmv.25678","article-title":"Outbreak of pneumonia of unknown etiology in Wuhan, China: the mystery and the miracle","volume":"92","author":"Lu","year":"2020","journal-title":"J Med Virol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1016\/S2213-2600(20)30056-4","article-title":"Coronavirus in China","volume":"8","author":"Burki","year":"2020","journal-title":"Lancet Respir Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1016\/S0140-6736(20)30628-0","article-title":"COVID-19: consider cytokine storm syndromes and immunosuppression","volume":"395","author":"Mehta","year":"2020","journal-title":"Lancet."},{"key":"B4","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1001\/jama.2020.12603","article-title":"Persistent symptoms in patients after acute COVID-19","volume":"324","author":"Carf\u00ec","year":"2020","journal-title":"JAMA."},{"key":"B5","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1007\/s11926-021-01023-9","article-title":"COVID-19 and myositis: what we know so far","volume":"23","author":"Saud","year":"2021","journal-title":"Curr Rheumatol Rep."},{"key":"B6","doi-asserted-by":"publisher","first-page":"2548","DOI":"10.1111\/ene.15358","article-title":"Shoulder palsy following SARS-CoV-2 infection: two cases of typical parsonage-turner syndrome","volume":"29","author":"Fortanier","year":"2022","journal-title":"Eur J Neurol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1002\/ana.25987","article-title":"Incidence, clinical, risk factors and outcomes of guillain-barr\u00e9 in covid-19","volume":"89","author":"Fragiel","year":"2021","journal-title":"Ann Neurol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/s10072-021-05647-8","article-title":"Balance and visual reliance in post-COVID syndrome patients assessed with a robotic system: a multi-sensory integration deficit","volume":"43","author":"Gervasoni","year":"2022","journal-title":"Neurol Sci."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1001\/jama.2020.2648","article-title":"Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese center for disease control and prevention","volume":"323","author":"Wu","year":"2020","journal-title":"JAMA."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00415-022-11389-0","article-title":"Risk and course of COVID-19 in immunosuppressed patients with myasthenia gravis","volume":"270","author":"Stascheit","year":"2023","journal-title":"J Neurol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e2109","DOI":"10.1212\/WNL.0000000000011669","article-title":"Impact of coronavirus disease 2019 in a French cohort of myasthenia gravis","volume":"96","author":"Sol\u00e9","year":"2021","journal-title":"Neurology."},{"key":"B12","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1002\/mus.27919","article-title":"COVID-19 infection in myasthenia gravis: clinical course and outcomes","volume":"68","author":"Thomas","year":"2023","journal-title":"Muscle Nerve."},{"key":"B13","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1016\/S1474-4422(21)00297-0","article-title":"Epidemiology, diagnostics, and biomarkers of autoimmune neuromuscular junction disorders","volume":"21","author":"Punga","year":"2022","journal-title":"Lancet Neurol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"e16280","DOI":"10.1111\/ene.16280","article-title":"Expert consensus recommendations for improving and standardising the assessment of patients with generalised myasthenia gravis","volume":"31","author":"Meisel","year":"2024","journal-title":"Eur J Neurol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"e7","DOI":"10.1111\/ene.15158","article-title":"Predictive factors for a severe course of COVID-19 infection in myasthenia gravis patients with an overall impact on myasthenic outcome status and survival","volume":"29","author":"Jakubikova","year":"2022","journal-title":"Eur J Neurol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1056\/NEJMc2009567","article-title":"Covid-19 in immune-mediated inflammatory diseases - case series from New York","volume":"383","author":"Haberman","year":"2020","journal-title":"N Engl J Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1038\/s41582-020-0385-8","article-title":"Neurological immunotherapy in the era of COVID-19 - looking for consensus in the literature","volume":"16","author":"Korsukewitz","year":"2020","journal-title":"Nat Rev Neurol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.tmaid.2019.03.004","article-title":"Clinical predictors of mortality of middle east respiratory syndrome coronavirus (MERS-CoV) infection: a cohort study","volume":"29","author":"Alfaraj","year":"2019","journal-title":"Travel Med Infect Dis."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/mus.27747","article-title":"Vaccination against COVID-19 does not lead to exacerbation in patients with myasthenia gravis","volume":"67","author":"Breiner","year":"2023","journal-title":"Muscle Nerve."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.3390\/vaccines9101112","article-title":"COVID-19 vaccination in patients with myasthenia gravis: a single-center case series","volume":"9","author":"Ruan","year":"2021","journal-title":"Vaccines."},{"key":"B21","doi-asserted-by":"publisher","first-page":"e21","DOI":"10.1016\/S0140-6736(23)00810-3","article-title":"6-month consequences of COVID-19 in patients discharged from hospital: a cohort study","volume":"401","author":"Huang","year":"2023","journal-title":"Lancet."},{"key":"B22","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1038\/s41586-022-05542-y","article-title":"SARS-CoV-2 infection and persistence in the human body and brain at autopsy","volume":"612","author":"Stein","year":"2022","journal-title":"Nature."},{"key":"B23","doi-asserted-by":"publisher","first-page":"e2127403","DOI":"10.1001\/jamanetworkopen.2021.27403","article-title":"Symptoms and health outcomes among survivors of covid-19 infection 1 year after discharge from hospitals in Wuhan, China","volume":"4","author":"Zhang","year":"2021","journal-title":"JAMA Netw Open."},{"key":"B24","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1002\/jmv.25728","article-title":"The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients","volume":"92","author":"Li","year":"2020","journal-title":"J Med Virol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"n1648","DOI":"10.1136\/bmj.n1648","article-title":"Long covid-mechanisms, risk factors, and management","volume":"374","author":"Crook","year":"2021","journal-title":"BMJ."},{"key":"B26","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1016\/S2215-0366(20)30203-0","article-title":"Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic","volume":"7","author":"Rogers","year":"2020","journal-title":"Lancet Psychiatry."},{"key":"B27","doi-asserted-by":"publisher","first-page":"7264","DOI":"10.1128\/JVI.00737-08","article-title":"Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2","volume":"82","author":"Netland","year":"2008","journal-title":"J Virol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1038\/s41582-020-0402-y","article-title":"Lung innervation in the eye of a cytokine storm: neuroimmune interactions and COVID-19","volume":"16","author":"De Virgiliis","year":"2020","journal-title":"Nat Rev Neurol."},{"key":"B29","doi-asserted-by":"crossref","first-page":"2452","DOI":"10.1016\/j.cell.2022.06.008","article-title":"Mild respiratory COVID can cause multi-lineage neural cell and myelin dysregulation","volume":"185","author":"Fern\u00e1ndez-Casta\u00f1eda","year":"2022","journal-title":"Cell."},{"key":"B30","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1097\/PHM.0000000000002291","article-title":"Sarcopenia and multisensory integration deficit in post-COVID syndrome patients: the clinical, ultrasound and robotic evaluation protocol in a cross-sectional study","volume":"103","author":"LoMauro","year":"2024","journal-title":"Am J Phys Med Rehabil."},{"key":"B31","doi-asserted-by":"publisher","first-page":"3537","DOI":"10.1111\/ene.14721","article-title":"Myasthenia gravis associated with anti-MuSK antibodies developed after SARS-CoV-2 infection","volume":"28","author":"Assini","year":"2021","journal-title":"Eur J Neurol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"872","DOI":"10.7326\/L20-1298","article-title":"MuSK Antibody-associated Myasthenia Gravis with SARS-CoV-2 infection: a case report","volume":"174","author":"Muhammed","year":"2021","journal-title":"Ann Intern Med."},{"key":"B33","doi-asserted-by":"publisher","first-page":"118185","DOI":"10.1016\/j.lfs.2020.118185","article-title":"The immune system as a target for therapy of SARS-CoV-2: a systematic review of the current immunotherapies for COVID-19","volume":"258","author":"Mansourabadi","year":"2020","journal-title":"Life Sci."},{"key":"B34","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1007\/s13760-021-01612-6","article-title":"Myasthenia gravis at the crossroad of COVID-19: focus on immunological and respiratory interplay","volume":"121","author":"Galassi","year":"2021","journal-title":"Acta Neurol Belg."},{"key":"B35","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1136\/thx.49.7.703","article-title":"Breathing pattern and central ventilatory drive in mild and moderate generalised myasthenia gravis","volume":"49","author":"Garc\u00eda","year":"1994","journal-title":"Thorax."},{"key":"B36","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/s12931-021-01614-1","article-title":"Conceptions of the pathophysiology of happy hypoxemia in COVID-19","volume":"22","author":"Dhont","year":"2021","journal-title":"Respir Res."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1513649\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T12:28:46Z","timestamp":1744115326000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1513649\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,2]]},"references-count":36,"alternative-id":["10.3389\/fneur.2025.1513649"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1513649","relation":{},"ISSN":["1664-2295"],"issn-type":[{"type":"electronic","value":"1664-2295"}],"subject":[],"published":{"date-parts":[[2025,4,2]]},"article-number":"1513649"}}