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Clinical Features and Outcomes of Myasthenia Gravis Associated With Covid-19 Vaccines: A Systematic Review and Pooled Analysis Publisher Pubmed



Tayebi AH1 ; Samimisedeh P1 ; Jafari Afshar E1 ; Ayati A2 ; Ghalehnovi E3 ; Foroutani L2 ; Abbasi Khoshsirat N4 ; Rastad H1
Authors
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Authors Affiliations
  1. 1. Cardiovascular Research Center, Alborz University of Medical Sciences, Karaj, Iran
  2. 2. Faculty of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
  3. 3. Razi Vaccine and Serum Research Institute, Karaj, Iran
  4. 4. Department of Neurology, Shahid Rajaei Hospital, Alborz University of Medical Sciences, Karaj, Iran

Source: Medicine (United States) Published:2023


Abstract

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. © 2023 Lippincott Williams and Wilkins. All rights reserved.
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