[pubmed] A case report of COVID-19 in refractory myasthenia: Outcome with remdesivir and dexamethasone

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Medicine (Baltimore). 2021 May 7;100(18):e25701. doi: 10.1097/MD.0000000000025701.

ABSTRACT

RATIONALE: Myasthenia gravis (MG) patients are at increased risk of COVID-19 infection and its complications due to chronic immunosuppression. COVID-19 infection can also increase the risk of myasthenia exacerbation.

PATIENT CONCERNS: The patient presented with respiratory distress, fever and chills and was diagnosed with COVID-19 pneumonia. His past medical history includes seropositive generalized MG diagnosed in 2019, hypertension, atrial fibrillation and congestive heart failure with reduced ejection failure.

DIAGNOSES: Refractory seropositive generalized MG having COVID-19 pneumonia and respiratory failure (needing mechanical ventilation) with sepsis.

INTERVENTION: Use of intravenous remdesivir and dexamethasone and patient's myasthenic exacerbation (due to COVID-19 and its complications) was successfully treated with plasmapheresis.

OUTCOMES: Patient was successfully weaned off ventilator to trach collar and was discharged to inpatient rehabiliation. He was followed up 1 month post hospital discharge and was on trach collar.

LESSONS: This case report illustrates early use of the combination therapy might be beneficial in refractory myasthenia gravis cases even with chronic immunosuppression and severe COVID-19 infection.

PMID:33950951 | DOI:10.1097/MD.0000000000025701


Source: https://pubmed.ncbi.nlm.nih.gov/3395095 ... 7&v=2.14.4