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031 COVID-19 disease outcomes in a UK Myasthenia Centre during the first year of the pandemic
  1. Paul Kopanidis1,
  2. Mary Quirke1,
  3. Camilla Buckley1 and
  4. Isabel Leite2
  1. 1John Radcliffe Hospital, Oxford, OXFORDSHIRE, UK
  2. 2Nuffield Department of Neurosciences, Oxford, UK


Objectives Describe the outcomes of patients treated at the Myasthenia Centre at Oxford University Trust who developed COVID-19 during the first year of the pandemic.

Methods Retrospective audit of patients diagnosed with COVID-19 between 31st January 2020 – 31st January 2021. Outcomes of COVID-19 complications, including relapse of myasthenia gravis (MG), were analysed.

Results The Myasthenia Centre treated 487 patients, including 370 with acetylcholine receptor (AChR) MG, 74 sero-negative MG, 20 MuSK MG and 23 Lambert-Eaton Myasthenic Syndrome (LEMS). COVID-19 was diagnosed in a total of twelve patients (2.5%) including ten AChR, one MuSK and one LEMS patient, with a mean age of 63.8 years (range 20 – 92 years). Five patients were asymptomatic of MG prior to the diagnosis of COVID-19. Treatments prior to diagnosis included pyridostigmine (8/12), prednisolone (7/12), azathioprine (3/12), mycophenolate (1/12) and rituximab (1/12). The majority (8/12) had at least one other co-morbid risk factor for severe COVID-19.

COVID-19 resulted in hospital admission in six patients, with three requiring intensive care treatment. One patient with AChR MG (with NHL and NMO treated with rituximab) died from COVID-19 without MG relapse. Two elderly patients developed moderate COVID-19 after a single dose BioNTech vaccination without MG relapse.

MG relapse occurred in four patients post COVID-19, with two requiring inpatient management including IVIG.

Conclusion COVID-19 disease was associated with relapse of MG, with all patients in this group surviving. Further research is required to establish if COVID-19 precipitates MG relapse at a different rate compared to other infectious diseases.

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