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Clinical features and outcomes of Myasthenia Gravis associated with COVID-19 vaccines: A systematic review and pooled analysis

Title: Clinical features and outcomes of Myasthenia Gravis associated with COVID-19 vaccines: A systematic review and pooled analysis
Authors: Tayebi, Amir Hossein; Samimisedeh, Parham; Jafari Afshar, Elmira; Ayati, Aryan; Ghalehnovi, Elaheh; Foroutani, Laleh; Abbasi Khoshsirat, Nahid; Rastad, Hadith
Source: Medicine ; volume 102, issue 40, page e34890 ; ISSN 0025-7974 1536-5964
Publisher Information: Ovid Technologies (Wolters Kluwer Health)
Publication Year: 2023
Description: Backgrounds: Myasthenia Gravis (MG), a chronic neuromuscular junction disorder, emerged as one of the serious side effects of the Coronavirus Disease 2019 (COVID-19) vaccination. We aimed to summarize the findings of studies on the clinical features and outcomes of COVID-19 vaccination-associated MG. Methods: We performed a systematic search on 3 databases, Medline, Embase, and Scopus, using the query “COVID-19 vaccine” and “Myasthenia Gravis.” Patients’ data, including clinical data, MG subtype, vaccine type, and vaccine dose number, were extracted from the eligible studies. Results: A total of 20 COVID-19 vaccination-related MGs have been reported worldwide. The median (interquartile range) age was 64 (51, 75) years; 85% (17/20) of them were male, and 70% (14/20) of patients had received messenger RNA-based vaccines. The most common symptoms, in order of frequency, were binocular diplopia (8/11) and ptosis (4/11); the median (interquartile range) time from vaccine to MG symptoms was 6 (2, 7.5) days. Repetitive nerve stimulation showed abnormal decrement in 85% (11/13) of patients, and all 4 patients getting single-fiber electromyography showed an abnormal finding. Nine out of twelve patients with data on clinical outcomes experienced partial/complete improvement of symptoms within 1 month. Conclusion: MG cases after the COVID-19 vaccine are more likely to occur among males and adults older than 50 years. Our pooled cohort data suggest MG symptoms appear within 2 weeks after receiving the vaccine. The presenting symptoms in MG cases associated with COVID-19 vaccine are possibly similar to non-vaccination related MGs. Most patients are expected to experience partial/complete improvement within 1 month.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1097/md.0000000000034890
DOI: 10.1097/MD.0000000000034890
Availability: https://doi.org/10.1097/md.0000000000034890; https://journals.lww.com/10.1097/MD.0000000000034890
Rights: http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.C8335432
Database: BASE