Abstract

Myasthenia gravis is an autoimmune neuromuscular junction disease characterized by weakness and respiratory failure. Novel Coronavirus COVID-19/SARS-COV-2) presents as fever, cough, breathlessness and most commonly associated with pulmonary infiltrates. Myasthenia gravis can be unmasked or exacerbated by an infection, drugs like (statin, hydroxyl chloroquine and antibiotics) and non-compliance to medications. Symptomatic COVID-19 increases the work of breathing, and myasthenia gravis causes early fatigue of respiratory muscles leading to respiratory failure. Here we are reporting an undiagnosed case of myasthenia gravis with myasthenic crisis unmasked by COVID-19. Our patient presented with respiratory distress and developed respiratory failure, which required mechanical ventilation. He did not respond to treatment and succumbed to death, despite adequate efforts. This indicates early suspicion of myasthenia and consideration for immunosuppression therapy in such patients for a better outcome.

Keywords: Myasthenia gravis; Novel Coronavirus (COVID-19/ SARS-COV-2); Hydroxyl chloroquine; Respiratory failure; immunosuppression