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.
【저자키워드】 Dexamethasone, Coronavirus disease 2019, Remdesivir, Steroids, myasthenia gravis, 【초록키워드】 COVID-19, Dexamethasone, COVID-19 pneumonia, Respiratory failure, mechanical ventilation, Pneumonia, Immunosuppression, Remdesivir, risk, combination therapy, Sepsis, hypertension, Case report, heart failure, Atrial fibrillation, COVID-19 infection, Fever, Patient, Complication, complications, congestive heart failure, Plasmapheresis, myasthenia gravis, seropositive, distress, Myasthenia, respiratory distress, medical history, Severe COVID-19 Infection, ventilator, increased risk, diagnoses, hospital discharge, chills, Intravenous remdesivir, past medical history, chill, refractory, include, diagnosed, reduced, treated, discharged, diagnosed with COVID-19, 【제목키워드】 COVID-19, Dexamethasone, Remdesivir, Case report,