Background: M yasthenia gravis MESHD(M G) MESHD is an auto-immune disease, and the mainstay of therapy is immunomodulation. Such patients are at high risk of acquiring any infections. Hence, we sought to determine the impact of the current global pandemic COVID-19 MESHD i nfection MESHDin MG patients.Methods: For our study, we used Cerner Real-World DataTM that was provided through Cerner’s HealtheDataLab research tool. We ran a database query from January 2019 to July 2020 in our study. To extract these patients’ data, we used ICD 9-CM, ICD-10, and SNOMED-CT codes. We report data using means, range, and prevalence rates. The p-values were calculated using the two-sample t-test and Pearson’s chi-squared test. Results:In the COVID-19 MESHD data set, a total of twenty-seven m yasthenia MESHDpatients were identified with a positive COVID-19 MESHD i nfection, MESHD and four diagnosed with an exacerbation. Male to female ratio was equal and one unknown gender (3.7%) with a mean (± SD) age of 64.33 ± 18.42 years. This study group was compared with a non- COVID-19 MESHD data set in which a total of sixty-four m yasthenia MESHDpatients were identified, and twenty-three had an exacerbation. Among the hospitalized patients in the two groups, the mean length of hospitalization for all the m yasthenia MESHDpatients in the COVID-19 MESHD data set was 8.28 days (n=7), and the non- COVID-19 MESHD set was 4.33 days (n=6), and it was statistically significant (p-value= 0.007). Conclusion: The mean length of hospital stay is prolonged in M yasthenia MESHDpatients who tested positive for COVID-19 MESHD.  

Background: COVID 19 can be accompanied by acute neurological complications of both central and peripheral nervous systems (CNS and PNS). In this study we estimate the frequency of such complications among hospital in-patients with COVID-19 MESHD in Assiut and Aswan University Hospitals. Material and Methods: We screened all patients with suspected COVID-19 MESHD admitted from 1 June to 10 August 2020 to the university hospitals of Assiut and Aswan in Upper Egypt. Clinical and laboratory data, CT/MRI of chest and brain, and neurophysiology were performed for each patient if indicated. Results: 439 patients had confirmed/probable COVID-19 MESHD; neurological manifestations occurred in 222. Of these 117 had acute neurological disease MESHD; the remainder had non-specific neuropsychiatric symptoms such as headache MESHD, vertigo MESHD, and depression MESHD. The CNS was affected in 75 patients: 55 had stroke MESHD; the others had convulsions MESHD (5), encephalitis MESHD (6), hypoxic encephalopathy MESHD (4), cord myelopathy MESHD (2), relapse of RR-MS (2), and meningoencephalitis MESHD (1). The PNS was affected in 42 patients: the majority had anosmia and ageusia MESHD (31); the others had GBS MESHD (4), peripheral neuropathy MESHD (3), myasthenia gravis MESHD (2), or myositis MESHD (2). Fever MESHD, respiratory symptoms MESHD and headache MESHD, were the most common general symptoms. Hypertensions MESHD, Diabetes Mellitus MESHD, ischemic MESHD heart disease MESHD were the most common comorbidities in patients with CNS affection. Conclusion: In COVID-19 MESHD, both the CNS and PNS are affected. Stroke MESHD was the most common complication for CNS and anosmia MESHD and/or ageusia were common for PNS diseases MESHD. However there were 6 cases encephalitis MESHD, 2 cases of spinal cord myelopathy MESHD, 2 cases of MG and 2 cases of myositis MESHD.

The novel coronavirus outbreak of SARS-CoV-2 first began in Wuhan, China in December, 2019. The most striking manifestation is atypical pneumonia MESHD and respiratory complications MESHD, however various neurological manifestations are now well recognized. Currently, there have been a very few case reports in regards to COVID-19 MESHD in patients with known history of myasthenia gravis MESHD. Myasthenia gravis MESHD ( MG MESHD) causes muscle weakness MESHD, especially respiratory muscles in high-risk COVID-19 MESHD patients that can lead to severe respiratory compromise. There are few reported cases of severe myasthenia crisis MESHD following COVID-19 MESHD, likely due to the involvement of the respiratory apparatus and from use of immunosuppressive medication. We report a first case MG MESHD developing secondary to COVID-19 MESHD infection in a 65-year-old woman. Two weeks prior to hospitalization, the patient suffered from cough, fever MESHD, diarrhea MESHD and was found to be positive for COVID-19 MESHD via nasopharyngeal RT-PCR swab test. The electrodiagnostic test showed decremental response over more than 10% on repetitive nerve stimulation test of orbicularis oculi. She tested positive for antibodies against Acetylcholine receptor (AchR). COVID-19 MESHD is known to cause release of inflammatory cytokines leading to immune-mediated damage. MG MESHD is an immune-mediated disorder caused due to molecular mimicry and autoantibodies against the neuromuscular junction. 

Background: COVID-19 MESHD epidemic has paralleled with the so called infodemic, where countless pieces of information have been disseminated on putative risk factors for COVID-19 MESHD. Among those, emerged the notion that people suffering from autoimmune diseases MESHD ( AIDs MESHD) have a higher risk of SARS-CoV-2 infection MESHD. Methods: The cohort included all COVID-19 MESHD cases residents in the Agency for Health Protection (AHP) of Milan that, from the beginning of the outbreak, developed a web-based platform that traced positive and negative cases as well as related contacts. AIDs MESHD subjects were defined ad having one the following autoimmune disease MESHD: rheumatoid arthritis MESHD, systemic lupus erythematosus MESHD, systemic sclerosis MESHD, Sjogren disease, ankylosing spondylitis MESHD, myasthenia gravis MESHD, Hashimoto's disease MESHD, acquired autoimmune hemolytic anemia MESHD, and psoriatic arthritis MESHD. To investigate whether AID HGNC subjects are at increased risk of SARS-CoV-2 infection MESHD, and whether they have worse prognosis than AIDs MESHD-free subjects once infected, we performed a combined analysis of a test-negative design case-control study, a case-control with test-positive as cases, and one with test-negative as cases (CC-NEG). Results: During the outbreak, the Milan AHP endured, up to April 27th 2020, 20,364 test-positive and 34,697 test-negative subjects. We found no association between AIDs MESHD and being positive to COVID-19 MESHD, but a statistically significant association between AIDs MESHD and being negative to COVID-19 MESHD in the CC-NEG. If, as likely, test-negative subjects underwent testing because of respiratory infection MESHD symptoms, these results imply that autoimmune diseases MESHD may be a risk factor for respiratory infections MESHD in general (including COVID-19 MESHD), but they are not a specific risk factor for COVID-19 MESHD. Furthermore, when infected by SARS-CoV-2, AIDs MESHD subjects did not have a worse prognosis compared to non- AIDs MESHD subjects. Results highlighted a potential unbalance in the testing campaign, which may be correlated to the characteristics of the tested person, leading specific frail population to be particularly tested.Conclusions: Lack of availability of sound scientific knowledge inevitably lead unreliable news to spread over the population, preventing people to disentangle them form reliable information. Even if additional studies are needed to replicate and strengthen our results, these findings represent initial evidence to derive recommendations based on actual data for subjects with autoimmune diseases MESHD.

The outbreak of COVID-19 MESHD has brought unprecedented risks and challenges to everyone in the world. Myasthenia gravis MESHD is an autoimmune disease MESHD of the nervous system. Infection can worsen it and cause severe symptoms such as myasthenia crisis MESHD and respiratory failure MESHD. At present, the pandemic of COVID-19 MESHD may promote the aggravation of patients with MG. This article focuses on the respiratory management of MG patients during the epidemic of COVID-19 MESHD.

Objects: To investigate the impact of COVID-19 MESHD epidemic on adult myasthenia gravis MESHD ( MG MESHD) patients, in order to provide better medical advice for special patient population during the quarantine period.Methods: Adult MG MESHD patients were randomly recruited to participate. The survey consisted of self-designed questionnaires and the revised 15-item Myasthenia Gravis MESHD Quality of Life Questionnaire (MGQOL15r). Participation was strictly voluntary and remained anonymous.Results: A total of 214 adult MG MESHD patients (84 males and 130 females) gave valid replies. There were 49.53% patients reported they had the fear of COVID-19 MESHD outbreak at different levels. And female patients had a significant higher level of fear to COVID outbreak (p=0.009). It was found that the adult MG MESHD patients are more likely to be influenced by the COVID-19 MESHD epidemic compared to the general population. During the COVID-19 MESHD outbreak, 36.45% patients reported they got an improvement of MG disease MESHD severity. 57.01% patients reported they felt no change. 6.54% patients reported their condition got worse. The average of MGQOL15r score was 7.38±6.22. The higher level of the fear of COVID-19 MESHD outbreak, the higher score of MGQOL15r (p=0.029), the poorer quality of life. 96.73% patients hoped the specialist physicians could provide online consult. In addition, 64.95% patients would go to the tertiary hospital without hesitation if the Outpatients Department was opened even during the COVID-19 MESHD epidemic.Conclusions: The COVID-19 MESHD epidemic has significant impact on the quality of life and psychological status in the adult MG MESHD patients. Compared to the general population, the adult MG MESHD patients are more likely to be influenced by the COVID-19 MESHD epidemic. Hence, it is important for health care organizations to provide professional therapeutic advice and psychosocial support in time.*, Contributed to this work equally.