Follow-up of a Cohort of Patients With Myasthenic Syndrome and COVID-19 Infection
Follow-up of a Cohort of Patients With Myasthenic Syndrome and COVID-19 Infection
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.
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.
Inclusion Criteria:

 -  1. Child or adult patients, living or deceased, presenting or having presented a
 myasthenic syndrome and a COVID-19 infection 2. Myasthenic syndrome is established by:

 -  Either the presence of a specific antibody

 -  Either the presence of specific electrophysiological abnormalities

 -  Either an evocative symptomatology improved by a therapeutic test with an
 acetylcholinesterase inhibitor

 -  Either one or two pathogenic mutation (s) in a gene involved in congenital
 myasthenic syndromes (dominant or recessive disease).

 3. COVID-19 infection is established by

 -  Either a positive PCR test

 -  Or a specific chest scanner

 -  Either a positive serology

 -  Either a clinical syndrome of COVID-19, validated by a committee of experts. 4.
 Patients affiliated or beneficiaries of a social security scheme 5. For living
 patients: patients who have been informed of the study and have not exercised
 their right of opposition or parents or holders of parental authority who have
 been informed of the study and have not exercised their right opposition.

 For deceased patients: beneficiaries or parents / holders of parental authority having been
 informed of the study and not having exercised their right of objection.

 Exclusion Criteria:

 1. Persons placed under judicial protection