Review Article

Infeksi COVID-19 pada pasien myasthenia gravis: sebuah tinjauan pustaka

Made Ratna Dewi Setiawan , I Ketut Sumada

Made Ratna Dewi Setiawan
Puskesmas III Mengwi, Badung, Bali. Email: maderatnadewisetiawan@gmail.com

I Ketut Sumada
Departemen Neurologi, RS Wangaya, Denpasar Bali
Online First: April 30, 2021 | Cite this Article
Setiawan, M., Sumada, I. 2021. Infeksi COVID-19 pada pasien myasthenia gravis: sebuah tinjauan pustaka. Intisari Sains Medis 12(1): 285-289. DOI:10.15562/ism.v12i1.991


Coronavirus disease (COVID-19) has rapidly become a global pandemic and during this condition, there might be at greater risk of exacerbation in patients with myasthenia gravis. This is related to the viral infection that has been known to increase the risk of a myasthenic crisis. In addition, some experimental drugs used in COVID-19 has been reported to increase the risk of exacerbation in patient with myasthenia gravis. In the other hand, several studies show higher morbidity and mortality rates due to COVID-19 in patient with myasthenia gravis. Myasthenia gravis might be a risk factor for severe COVID-19 infection due to several mechanisms, such as the effect of the immunosuppressive therapy and the inherent respiratory muscle weakness and vulnerabilities. The comprehensive study based on several case report is needed to respond the needs of adaptation in treating patient with myasthenia gravis during this pandemic era.

 

 

Coronavirus disease (COVID-19) telah menjadi pandemi global dalam waktu singkat. Selama pandemi ini, terdapat peningkatan resiko eksaserbasi pada pasien dengan myasthenia gravis. Hal ini terjadi karena sejak lama telah diketahui bahwa infeksi virus dapat meningkatkan resiko krisis myasthenia pada pasien myasthenia gravis. Beberapa obat eksperimental yang diberikan pada pasien dengan infeksi COVID-19 juga dilaporkan memiliki resiko yang tinggi dalam menimbulkan eksaserbasi gejala myasthenia gravis. Di sisi lain, beberapa studi terkait COVID-19 menunjukkan angka morbiditas dan mortalitas yang lebih tinggi pada pasien dengan myasthenia gravis. Myasthenia gravis juga merupakan faktor resiko untuk infeksi COVID-19 berat yang berhubungan degan beberapa mekanisme seperti efek dari terapi imunosupresan dan kondisi kelemahan otot pernafasan pada penyakit myasthenia gravis. Telaah yang komprehensif berdasarkan beberapa laporan kasus terkait infeksi COVID-19 pada pasien myasthenia gravis sangat diperlukan untuk melakukan adaptasi manajemen terapi pada era pandemi ini.

References

WHO. Coronavirus disease (COVID-19) situation reports [Internet]. World Health Organisation. 2020. p. 1. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports

Muppidi S, Guptill JT, Jacob S, Li Y, Farrugia ME, Guidon AC, et al. COVID-19-associated risks and effects in myasthenia gravis (CARE-MG). Lancet Neurol. 2020;19(12):970–1. Available from: https://pubmed.ncbi.nlm.nih.gov/33212055

Aksoy E, Oztutgan T. COVID-19 Presentation in Association with Myasthenia Gravis: A Case Report and Review of the Literature. Case Rep Infect Dis. 2020;2020:8845844. Available from: https://pubmed.ncbi.nlm.nih.gov/32850160

Chairunisa N, Zanariah Z, Saputra O, Karyanto K. Myasthenia gravis pada Pasien Laki-laki 39 Tahun dengan Sesak Napas. Medula. 2016;6(1):108–14. Available from: http://juke.kedokteran.unila.ac.id/index.php/medula/article/view/858

Camelo-Filho AE, Silva AMS, Estephan EP, Zambon AA, Mendonça RH, Souza PVS, et al. Myasthenia Gravis and COVID-19: Clinical Characteristics and Outcomes. Front Neurol. 2020;11:1053. Available from: https://pubmed.ncbi.nlm.nih.gov/33013676

Fares E, Tayyar R, Pathak K, Damiano C, Kuntz C. Myasthenia gravis crisis triggered by covid-19. Chest. 2020;158(4):A734. Available from: http://dx.doi.org/10.1016/j.chest.2020.08.688

Anand P, Slama MCC, Kaku M, Ong C, Cervantes-Arslanian AM, Zhou L, et al. COVID-19 in patients with myasthenia gravis. Muscle Nerve. 2020;62(2):254–8. Available from: https://pubmed.ncbi.nlm.nih.gov/32392389

Arie A. GAA, Adnyana MO, Widyadharma IPE. Myasthenia gravis, diagnosis and treatment. E-jurnal Med Udayana. 2013;2(6):1012–35. Available from: https://ojs.unud.ac.id/index.php/eum/article/view/5622

Jayam Trouth A, Dabi A, Solieman N, Kurukumbi M, Kalyanam J. Myasthenia gravis: a review. Autoimmune Dis. 2012;2012:874680. Available from: https://pubmed.ncbi.nlm.nih.gov/23193443

Statland JM, Ciafaloni E. Myasthenia gravis: Five new things. Neurol Clin Pract. 2013;3(2):126–33. Available from: https://pubmed.ncbi.nlm.nih.gov/23914322

Harkitasari S. Diagnosis dan Terapi Miastenia Gravis pada Anak. Cermin Dunia Kedokt. 2015;42(3):181–5. Available from: http://www.cdkjournal.com/index.php/CDK/article/view/1030

Farmakidis C, Pasnoor M, Dimachkie MM, Barohn RJ. Treatment of Myasthenia Gravis. Neurol Clin. 2018;36(2):311–37. Available from: https://pubmed.ncbi.nlm.nih.gov/29655452

Sriwastava S, Tandon M, Kataria S, Daimee M, Sultan S. New onset of ocular myasthenia gravis in a patient with COVID-19: a novel case report and literature review. J Neurol. 2020;1–7. Available from: https://pubmed.ncbi.nlm.nih.gov/33047223

Baig AM, Khaleeq A, Ali U, Syeda H. Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host-Virus Interaction, and Proposed Neurotropic Mechanisms. ACS Chem Neurosci. 2020;11(7):995–8. Available from: https://pubmed.ncbi.nlm.nih.gov/32167747

Herold T, Jurinovic V, Arnreich C, Lipworth BJ, Hellmuth JC, von Bergwelt-Baildon M, et al. Elevated levels of IL-6 and CRP predict the need for mechanical ventilation in COVID-19. J Allergy Clin Immunol. 2020;146(1):128-136.e4. Available from: https://pubmed.ncbi.nlm.nih.gov/32425269

Ellul MA, Benjamin L, Singh B, Lant S, Michael BD, Easton A, et al. Neurological associations of COVID-19. Lancet Neurol. 2020;19(9):767–83. Available from: https://pubmed.ncbi.nlm.nih.gov/32622375

Singh S, Govindarajan R. COVID-19 and generalized Myasthenia Gravis exacerbation: A case report. Clin Neurol Neurosurg. 2020;196:106045. Available from: https://pubmed.ncbi.nlm.nih.gov/32634699

Murthy S, Gomersall CD, Fowler RA. Care for Critically Ill Patients With COVID-19. JAMA. 2020;323(15):1499. Available from: http://dx.doi.org/10.1001/jama.2020.3633

Meng L, Qiu H, Wan L, Ai Y, Xue Z, Guo Q, et al. Intubation and Ventilation amid the COVID-19 Outbreak: Wuhan’s Experience. Anesthesiology. 2020;132(6):1317–32. Available from: https://pubmed.ncbi.nlm.nih.gov/32195705

Group IM-19 W, Jacob S, Muppidi S, Guidon A, Guptill J, Hehir M, et al. Guidance for the management of myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) during the COVID-19 pandemic. J Neurol Sci. 2020;412:116803. Available from: https://pubmed.ncbi.nlm.nih.gov/32247193

Sanders DB, Wolfe GI, Benatar M, Evoli A, Gilhus NE, Illa I, et al. International consensus guidance for management of myasthenia gravis: Executive summary. Neurology. 2016;87(4):419–25. Available from: https://pubmed.ncbi.nlm.nih.gov/27358333

Moschella P, Roth P. Isolated COVID-19 Infection Precipitates Myasthenia Gravis Crisis: A Case Report. Clin Pract cases Emerg Med. 2020;4(4):524–6. Available from: https://pubmed.ncbi.nlm.nih.gov/33217262

Gilhus NE, Romi F, Hong Y, Skeie GO. Myasthenia gravis and infectious disease. J Neurol. 2018;265(6):1251–8. Available from: http://dx.doi.org/10.1007/s00415-018-8751-9

Jallouli M, Saadoun D, Eymard B, Leroux G, Haroche J, Thi Huong D, et al. The association of systemic lupus erythematosus and myasthenia gravis: a series of 17 cases, with a special focus on hydroxychloroquine use and a review of the literature. J Neurol. 2011;259(7):1290–7. Available from: http://dx.doi.org/10.1007/s00415-011-6335-z

Jonsson DI, Pirskanen R, Piehl F. Beneficial effect of tocilizumab in myasthenia gravis refractory to rituximab. Neuromuscul Disord. 2017;27(6):565–8. Available from: http://dx.doi.org/10.1016/j.nmd.2017.03.007

Ayzenberg I, Kleiter I, Schröder A, Hellwig K, Chan A, Yamamura T, et al. Interleukin 6 Receptor Blockade in Patients With Neuromyelitis Optica Nonresponsive to Anti-CD20 Therapy. JAMA Neurol. 2013;70(3):394. Available from: http://dx.doi.org/10.1001/jamaneurol.2013.1246

Rein N, Haham N, Orenbuch-Harroch E, Romain M, Argov Z, Vaknin-Dembinsky A, et al. Description of 3 patients with myasthenia gravis and COVID-19. J Neurol Sci. 2020;417:117053. Available from: https://pubmed.ncbi.nlm.nih.gov/32731059

The RECOVERY Collaborative Group. Dexamethasone in Hospitalized Patients with Covid-19. N Engl J Med. 2021;384(8):693–704. Available from: http://www.nejm.org/doi/10.1056/NEJMoa2021436


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