{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:22:19Z","timestamp":1787775739976,"version":"build-2784847793"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>This report describes a patient with thymomatous myasthenia gravis (MG) with aplastic anemia in pharmacological remission and COVID-19 who developed respiratory failure in the course of the disease and reviews the published literature on this topic. Analysis of the clinical characteristics of the eight patients with MG including our patient suggests two possible mechanisms for respiratory failure: myasthenic crisis (MC) or pulmonary complications of COVID-19. Patients with MC were young women in high-grade MGFA Class whereas patients with respiratory failure due to pulmonary complications of COVID-19 were elderly men in pharmacological remission or MGFA Class I. These observations suggest that COVID-19, like other infections, may precipitate MC in patients with severe grade MG before COVID-19. The only differentiating feature between the two types of failure was severity myasthenic weakness. This clinical distinction has management implications. These observations need to be validated in a larger sample.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/0028-3886.333460","type":"journal-article","created":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T01:47:50Z","timestamp":1640656070000},"page":"1772-1776","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["COVID-19 in Patients with Myasthenia Gravis"],"prefix":"10.4103","volume":"69","author":[{"given":"Jagarlapudi M.K.","family":"Murthy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhinay K.","family":"Gutta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muralidhar Reddy","family":"Yerasu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santhosh Kumar","family":"Boorgu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed","family":"Osman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shyam K.","family":"Jaiswal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lalitha","family":"Pidaparthi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavani P.","family":"Gudavalli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-53-20240907","doi-asserted-by":"crossref","first-page":"3104","DOI":"10.1093\/brain\/awaa240","article-title":"The emerging spectrum of COVID-19 neurology: Clinical, radiological and laboratory findings","volume":"143","author":"Paterson","year":"2020","journal-title":"Brain"},{"key":"R2-53-20240907","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/S1474-4422(20)30221-0","article-title":"Neurological associations of COVID-19","volume":"19","author":"Ellul","year":"2020","journal-title":"Lancet Neurol"},{"key":"R3-53-20240907","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1212\/WNL.0000000000009566","article-title":"COVID-19 and neuromuscular disorders","volume":"94","author":"Guidon","year":"2020","journal-title":"Neurology"},{"key":"R4-53-20240907","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1212\/WNL.55.1.16","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":"55","author":"Jaretzki","year":"2000","journal-title":"Neurology"},{"key":"R5-53-20240907","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1002\/mus.26689","article-title":"Factors associated with acute exacerbations of myasthenia gravis","volume":"60","author":"Gummi","year":"2019","journal-title":"Muscle Nerve"},{"key":"R6-53-20240907","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1007\/s00415-018-8751-9","article-title":"Myasthenia gravis and infectious disease","volume":"265","author":"Gilhus","year":"2018","journal-title":"J Neurol"},{"key":"R7-53-20240907","doi-asserted-by":"crossref","first-page":"105949","DOI":"10.1016\/j.ijantimicag.2020.105949","article-title":"Hydroxychloroquine and azithromycin as a treatment of COVID-19: Results of an open-label non-randomized clinical trial","volume":"56","author":"Gautret","year":"2020","journal-title":"Int J Antimicrob Agents"},{"key":"R8-53-20240907","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/j.ijid.2020.06.099","article-title":"Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19","volume":"97","author":"Arshad","year":"2020","journal-title":"Int J Infect Dis"},{"key":"R9-53-20240907","first-page":"849","article-title":"Myasthenia gravis due to hydroxychloroquine","volume":"67","author":"Varan","year":"2015","journal-title":"Reumatismo"},{"key":"R10-53-20240907","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1136\/jnnp-2020-323565","article-title":"Management of patients with generalized myasthenia gravis and COVID-19: Four case reports","volume":"91","author":"H\u00fcbers","year":"2020","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R11-53-20240907","doi-asserted-by":"crossref","first-page":"116888","DOI":"10.1016\/j.jns.2020.116888","article-title":"Myasthenic crisis in COVID-19","volume":"414","author":"Delly","year":"2020","journal-title":"J Neurol Sci"},{"key":"R12-53-20240907","doi-asserted-by":"crossref","first-page":"106045","DOI":"10.1016\/j.clineuro.2020.106045","article-title":"COVID-19 and generalized myasthenia gravis exacerbation: A case report","volume":"196","author":"Singh","year":"2020","journal-title":"Clin Neurol Neurosurg"},{"key":"R13-53-20240907","doi-asserted-by":"crossref","first-page":"117053","DOI":"10.1016\/j.jns.2020.117053","article-title":"Description of 3 patients with myasthenia gravis and COVID-19","volume":"417","author":"Rein","year":"2020","journal-title":"J Neurol Sci"},{"key":"R14-53-20240907","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1002\/mus.26918","article-title":"COVID-19 in patients with myasthenia gravis","volume":"62","author":"Anand","year":"2020","journal-title":"Muscle Nerve"},{"key":"R15-53-20240907","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1212\/WNL.0000000000002790","article-title":"International consensus guidance for management of myasthenia gravis","volume":"87","author":"Sanders","year":"2016","journal-title":"Neurology"},{"key":"R16-53-20240907","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.3389\/fneur.2020.01053","article-title":"Myasthenia gravis and COVID-19: Clinical characteristics and outcomes","volume":"11","author":"Camelo-Filho","year":"2020","journal-title":"Front Neurol"},{"key":"R17-53-20240907","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1016\/S1474-4422(20)30413-0","article-title":"COVID-19-associated risks and effects in myasthenia gravis (CARE-MG)","volume":"19","author":"Muppidi","year":"2020","journal-title":"Lancet Neurol"},{"key":"R19-53-20240907","doi-asserted-by":"crossref","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"}],"container-title":["Neurology India"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/0028-3886.333460","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:41:04Z","timestamp":1787773264000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/0028-3886.333460"}},"subtitle":["Mechanisms of Respiratory Failure"],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":18,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/0028-3886.333460","relation":{},"ISSN":["0028-3886"],"issn-type":[{"value":"0028-3886","type":"print"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}