The Impact of COVID-19 Vaccination and Infection on the Exacerbation of Myasthenia Gravis.

IF 5.2 3区医学 Q1 IMMUNOLOGY

Vaccines Pub Date : 2024-10-27 DOI:10.3390/vaccines12111221

Yuting Jiang, Jingsi Wang, Shengyao Su, Shu Zhang, Qi Wen, Yaye Wang, Ling Li, Jianxin Han, Nairong Xie, Haoran Liu, Yanan Sun, Yan Lu, Li Di, Min Wang, Min Xu, Hai Chen, Suobin Wang, Xinmei Wen, Wenjia Zhu, Yuwei Da

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引用次数: 0

Abstract

Objectives: Myasthenia Gravis (MG) is an autoimmune disorder that can exacerbate for various reasons, including vaccination and infection. This study aimed to investigate the safety of COVID-19 vaccines for MG patients, factors influencing MG exacerbation after COVID-19 infection (MECI), the course and prognosis of MECI, and the impact of COVID-19 vaccine on infected MG patients.

Methods: Patients were enrolled from the MG database in the Department of Neurology, Xuanwu Hospital, Capital Medical University. Two questionnaires were administered to collect data concerning COVID-19 vaccination (questionnaire 1, Q1) and infection (questionnaire 2, Q2) during two distinct periods. MG exacerbation was defined as an increase of at least two points in the MG activity of daily living (MG-ADL) score. COVID-19 severity was categorized as "hospitalization" or "home management"; Results: During the first data-collecting period, our database registered 1013 adult patients: 273 (26.9%) had received COVID-19 vaccinations and completed Q1, and 8 (2.9%) experienced MG exacerbation after vaccination. During the second data-collecting period, among the newly registered patients, 366 patients completed Q2. Of these, 244 were infected, with 39 (16.0%) experiencing MECI and 21 (8.6%) requiring hospitalization. Multivariate analysis showed that generalized myasthenia gravis was associated with MECI (OR 3.354, 95% CI: 1.423-7.908, p = 0.006). Among the 244 infected patients, 143 had received COVID-19 vaccinations, including 14 who received their booster dose within 6 months before COVID-19 and 129 who were vaccinated more than 6 months before COVID-19. The remaining 101 were unvaccinated. No significant associations were found between COVID-19 vaccination and COVID-19 severity (p = 0.292) or MECI incidence (p = 0.478); Conclusions: COVID-19 vaccines were found to be safe for MG patients in stable condition. Patients with gMG were more susceptible to experiencing MECI. No significant impact of the vaccine on COVID-19 severity or MECI incidence was observed.

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接种 COVID-19 疫苗和感染对重症肌无力恶化的影响

目的：重症肌无力（MG）是一种自身免疫性疾病，可因接种疫苗和感染等各种原因而加重。本研究旨在探讨 COVID-19 疫苗对 MG 患者的安全性、COVID-19 感染（MECI）后 MG 加重的影响因素、MECI 的病程和预后以及 COVID-19 疫苗对感染的 MG 患者的影响：方法：患者来自首都医科大学宣武医院神经内科的MG数据库。在两个不同的时间段内发放了两份问卷，以收集有关 COVID-19 疫苗接种（问卷 1，Q1）和感染（问卷 2，Q2）的数据。MG恶化的定义是MG日常生活活动（MG-ADL）评分增加至少两分。COVID-19 的严重程度分为 "住院治疗 "和 "居家管理 "两种；结果：在第一个数据收集期，我们的数据库登记了 1013 名成年患者：273人（26.9%）接种了COVID-19疫苗并完成了Q1，8人（2.9%）在接种疫苗后出现了MG恶化。在第二个数据收集期，新登记的患者中有 366 人完成了第二季度的接种。其中 244 人受到感染，39 人（16.0%）出现 MECI，21 人（8.6%）需要住院治疗。多变量分析显示，全身性肌无力与 MECI 相关（OR 3.354，95% CI：1.423-7.908，p = 0.006）。在244名感染者中，143人接种过COVID-19疫苗，其中14人在COVID-19之前6个月内接种过加强剂，129人在COVID-19之前6个月以上接种过疫苗。其余 101 人未接种疫苗。COVID-19疫苗接种与COVID-19严重程度（p = 0.292）或MECI发病率（p = 0.478）之间未发现明显关联；结论：COVID-19疫苗对病情稳定的MG患者是安全的。重症肌无力患者更容易发生 MECI。未观察到疫苗对 COVID-19 严重程度或 MECI 发生率有明显影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccines Pharmacology, Toxicology and Pharmaceutics-Pharmacology

CiteScore

8.90

自引率

16.70%

发文量

1853

审稿时长

18.06 days

期刊介绍： Vaccines (ISSN 2076-393X) is an international, peer-reviewed open access journal focused on laboratory and clinical vaccine research, utilization and immunization. Vaccines publishes high quality reviews, regular research papers, communications and case reports.