Objective Myasthenia gravis (MG) is characterized by fluctuating muscle weakness due to immune mediated damage of acetylcholine receptor (AchR). COVID-19 infection, mental stress and non-availability of drugs following lockdown may worsen myasthenic symptoms. We report the impact of COVID 19, and lockdown on the physical and mental health, and quality of sleep in a cohort of MG. Methods Thirty-eight MG patients were telephonically interviewed 2months after the declaration of lockdown in India. The difficulty in procuring drugs, complications, and worsening in the MG Foundation of America (MGFA) stage were noted. The patients were enquired about MG Quality of Life 15 (MGQOL15), MG Activity of Daily Living (MGADL), Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI) using a prefixed questionnaire. Their pre-COVID parameters were retrieved from our earlier trial data, which was completed 4months back. The scores of the above mentioned parameters before and after COVID were compared. Results Their median age was 45 years, and the median duration of treatment for MG was 4.5years. Eleven (28.9%) patients were hypertensive and 3(7.9%) diabetic. All were on prednisolone and 18(47.4%) received azathioprine. None developed COVID, but three had other infections. Two patients needed hospitalization because of wrong medication in one and severe anxiety-insomnia in another. Following COVID19 and lockdown, MG patients had worsening in MGQOL15, MGADL, HADS and PSQI scores. Pittsburgh Sleep Quality Index score correlated with MGQOL15 and dose of acetylcholine esterase inhibitors. Conclusion COVID-19 and lockdown were associated with anxiety, depression, poor MGQOL and sleep especially in severe MG patients.

中文翻译：

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COVID-19 大流行和封锁对印度重症肌无力患者队列的影响

目的 重症肌无力 (MG) 的特征是由于免疫介导的乙酰胆碱受体 (AchR) 损伤导致的肌肉无力波动。COVID-19 感染、精神压力和封锁后无法获得药物可能会加重肌无力症状。我们报告了 COVID 19 的影响，以及封锁对一组重症肌无力患者的身心健康和睡眠质量的影响。方法 在印度宣布封锁 2 个月后，对 38 名 MG 患者进行了电话采访。注意到在美国 MG 基金会 (MGFA) 阶段采购药物的困难、并发症和恶化。使用预先填写的问卷向患者询问 MG 生活质量 15 (MGQOL15)、MG 日常生活活动 (MGADL)、医院焦虑和抑郁量表 (HADS) 和匹兹堡睡眠质量指数 (PSQI)。他们的 COVID 前参数是从我们较早的试验数据中检索到的，该试验数据是在 4 个月前完成的。比较了 COVID 前后上述参数的得分。结果 他们的中位年龄为 45 岁，中位 MG 治疗持续时间为 4.5 年。11 名 (28.9%) 患者患有高血压，3 名 (7.9%) 患有糖尿病。所有人都服用了泼尼松龙，18 人 (47.4%) 接受了硫唑嘌呤。没有人患上 COVID，但有 3 人感染了其他疾病。两名患者需要住院治疗，一名是因为用药错误，另一名是严重的焦虑失眠。在 COVID19 和封锁之后，MG 患者的 MGQOL15、MGADL、HADS 和 PSQI 评分恶化。匹兹堡睡眠质量指数评分与 MGQOL15 和乙酰胆碱酯酶抑制剂的剂量相关。结论 COVID-19 和封锁与焦虑、抑郁、