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An observational study on the safety of COVID-19 vaccination in patients with myasthenia gravis.
Neurol Sci. 2023 Jul; 44(7):2239-2245.NS

Abstract

OBJECTIVE

There is concern that the coronavirus disease (COVID-19) vaccine may trigger or worsen autoimmune diseases. The objective of this study was to determine the impacts of COVID-19 vaccination on symptom severity in patients with myasthenia gravis (MG).

METHODS

A total of 106 enrolled patients with MG who were vaccinated against COVID-19 were followed up, and a questionnaire was used to document in detail the exacerbation of muscle weakness after vaccination and all other uncomfortable reactions after vaccination. Demographic, clinical characteristics, medication, and vaccination data were collected by follow-up interview. The main observation outcome was whether the MG symptoms of patients were exacerbated. The definition of exacerbation is according to the subjective feeling of the patient or a 2-point increase in daily life myasthenia gravis activity score relative to before vaccination, within 30 days after vaccination.

RESULTS

Of 106 enrolled patients [median age (SD) 41.0 years, 38 (35.8%) men, 53 (50.0%) with generalized MG, 74 (69.8%) positive for acetylcholine receptor antibody, and 21 (19.8%) with accompanying thymoma], muscle weakness symptoms were stable in 102 (96.2%) patients before vaccine inoculation. Muscle weakness worsened in 10 (9.4%) people after vaccination, of which 8 patients reported slight symptom worsening that resolved quickly (within a few days). Two (1.9%) of patients showed serious symptom aggravation that required hospitalization.

CONCLUSION

Our results suggest that inactivated virus vaccines against COVID-19 may be safe for patients with MG whose condition is stable. Patients with generalized MG may be more likely to develop increased muscle weakness after vaccination.

Links

Authors+Show Affiliations

Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.

Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.

Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.

Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.

Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.

Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.

Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.

Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.

School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, 510006, China.

Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China. Liuwb@mail.sysu.edu.cn.

MeSH

AdultFemaleHumansMaleCOVID-19COVID-19 VaccinesMuscle WeaknessMyasthenia GravisThymus NeoplasmsVaccination

Pub Type(s)

Observational Study

Journal Article

Language

eng

PubMed ID

37160544

Citation

Wang, H Y., et al. "An Observational Study On the Safety of COVID-19 Vaccination in Patients With Myasthenia Gravis." Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, vol. 44, no. 7, 2023, pp. 2239-2245.

Wang HY, Qiu L, Ou CY, et al. An observational study on the safety of COVID-19 vaccination in patients with myasthenia gravis. Neurol Sci. 2023;44(7):2239-2245.

Wang, H. Y., Qiu, L., Ou, C. Y., Lin, Z. Q., Huang, Z. D., Chen, P., Ma, Q., Lu, Y. R., Ran, H., & Liu, W. B. (2023). An observational study on the safety of COVID-19 vaccination in patients with myasthenia gravis. Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 44(7), 2239-2245. https://doi.org/10.1007/s10072-023-06811-y

Wang HY, et al. An Observational Study On the Safety of COVID-19 Vaccination in Patients With Myasthenia Gravis. Neurol Sci. 2023;44(7):2239-2245. PubMed PMID: 37160544.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - An observational study on the safety of COVID-19 vaccination in patients with myasthenia gravis. AU - Wang,H Y, AU - Qiu,L, AU - Ou,C Y, AU - Lin,Z Q, AU - Huang,Z D, AU - Chen,P, AU - Ma,Q, AU - Lu,Y R, AU - Ran,H, AU - Liu,W B, Y1 - 2023/05/09/ PY - 2022/12/05/received PY - 2023/04/10/accepted PY - 2023/6/12/medline PY - 2023/5/10/pubmed PY - 2023/5/9/entrez KW - COVID-19 vaccine KW - Myasthenia gravis KW - Outcome KW - Vaccination SP - 2239 EP - 2245 JF - Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology JO - Neurol Sci VL - 44 IS - 7 N2 - OBJECTIVE: There is concern that the coronavirus disease (COVID-19) vaccine may trigger or worsen autoimmune diseases. The objective of this study was to determine the impacts of COVID-19 vaccination on symptom severity in patients with myasthenia gravis (MG). METHODS: A total of 106 enrolled patients with MG who were vaccinated against COVID-19 were followed up, and a questionnaire was used to document in detail the exacerbation of muscle weakness after vaccination and all other uncomfortable reactions after vaccination. Demographic, clinical characteristics, medication, and vaccination data were collected by follow-up interview. The main observation outcome was whether the MG symptoms of patients were exacerbated. The definition of exacerbation is according to the subjective feeling of the patient or a 2-point increase in daily life myasthenia gravis activity score relative to before vaccination, within 30 days after vaccination. RESULTS: Of 106 enrolled patients [median age (SD) 41.0 years, 38 (35.8%) men, 53 (50.0%) with generalized MG, 74 (69.8%) positive for acetylcholine receptor antibody, and 21 (19.8%) with accompanying thymoma], muscle weakness symptoms were stable in 102 (96.2%) patients before vaccine inoculation. Muscle weakness worsened in 10 (9.4%) people after vaccination, of which 8 patients reported slight symptom worsening that resolved quickly (within a few days). Two (1.9%) of patients showed serious symptom aggravation that required hospitalization. CONCLUSION: Our results suggest that inactivated virus vaccines against COVID-19 may be safe for patients with MG whose condition is stable. Patients with generalized MG may be more likely to develop increased muscle weakness after vaccination. SN - 1590-3478 UR - https://www.unboundmedicine.com/medline/citation/37160544/ DB - PRIME DP - Unbound Medicine ER -