Follow-up of a Cohort of Patients With Myasthenic Syndrome and COVID-19 Infection
Condition: Myasthenia Gravis
MeSH terms: COVID-19; Myasthenia Gravis; Lambert-Eaton Myasthenic Syndrome
Study type: Observational

Summary: 
      Coronavirus disease 2019 (COVID-19), declared by the World Health Organization (WHO) as a
      "public health emergency of international concern" (January 31, 2020), has posed a
      significant threat to global health. This infectious disease, caused by the 'severe acute
      respiratory syndrome coronavirus-2'(SARS-CoV-2), was first reported in China at the end of
      2019. As other coronaviruses, SARS-CoV-2 primarily targets the human respiratory system. The
      most common symptoms are fever, fatigue, and dry cough. During the second week of the
      disease, part of patients may progress to shortness of breath, then hypoxemia and severe
      pneumonia. Acute respiratory distress syndrome (ARDS), linked to some risk factors such as
      advanced age and underlying comorbidities (hypertension, diabetes, cardiovascular disease,
      and cerebrovascular disease), may be fatal and needs early supportive therapy and monitoring.

      Some patients with COVID-19 experienced neurological complications including headache,
      dizziness, hypogeusia and/or anosmia, altered level of consciousness, strokes, seizures, and
      ataxia, less frequently neuromuscular disorders (NMD) such as acute inflammatory
      polyradiculoneuropathy. Among NMD, myasthenia gravis (MG) patients, particularly susceptible
      to infections causing crises, could be of special risk of COVID-19 ARDS. Some general
      recommendations were established for the management of NMD during the COVID-19 pandemic,with
      also specific recommendations for MG. However, only data on a small number of patients who
      were managed in hospital are currently available;in addition, only two cases of myasthenic
      crisis following COVID-19 were reported. For this reason, the French neuromuscular rare
      disease network (FILNEMUS: 'FILière NEuroMUSculaire') has created the 'CO-MY-COVID register'
      to describe the clinical course and prognosis of patients with COVID-19 and pre-existing
      myasthenic syndrome.
    

Detailed description: 
      Coronavirus disease 2019 (COVID-19), declared by the World Health Organization (WHO) as a
      "public health emergency of international concern" (January 31, 2020), has posed a
      significant threat to global health. This infectious disease, caused by the 'severe acute
      respiratory syndrome coronavirus-2'(SARS-CoV-2), was first reported in China at the end of
      2019. Nowadays, with the exception of Antarctica, COVID-19 is a worldwide pandemic that
      continues to spread around the world (8,065,966 known cases and 437,604 deaths in June 16,
      2020; https://gisanddata.maps.arcgis.com/). As other coronaviruses, SARS-CoV-2 primarily
      targets the human respiratory system. Its most convincing mode of transmission is inhalation
      of infectious aerosols or direct contact of infected people's droplets. The most common
      symptoms are fever, fatigue, and dry cough. During the second week of the disease, part of
      patients may progress to shortness of breath, then hypoxemia and severe pneumonia. Acute
      respiratory distress syndrome (ARDS), linked to some risk factors such as advanced age and
      underlying comorbidities (hypertension, diabetes, cardiovascular disease, and cerebrovascular
      disease), may be fatal and needs early supportive therapy and monitoring.

      Some patients with COVID-19 experienced neurological complications including headache,
      dizziness, hypogeusia and/or anosmia, altered level of consciousness, strokes, seizures, and
      ataxia, less frequently neuromuscular disorders (NMD) such as acute inflammatory
      polyradiculoneuropathy. Among NMD, myasthenia gravis (MG) patients, particularly susceptible
      to infections causing crises, could be of special risk of COVID-19 ARDS. Some general
      recommendations were established for the management of NMD during the COVID-19 pandemic,with
      also specific recommendations for MG. However, only data on a small number of patients who
      were managed in hospital are currently available;in addition, only two cases of myasthenic
      crisis following COVID-19 were reported. For this reason, the French neuromuscular rare
      disease network (FILNEMUS: 'FILière NEuroMUSculaire') has created the 'CO-MY-COVID register'
      to describe the clinical course and prognosis of patients with COVID-19 and pre-existing
      myasthenic syndrome.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Child or adult patients, living or deceased, presenting or having presented a myasthenic
        syndrome and a COVID-19 infection
      
Keywords: COVID-19; Neuromuscular Diseases