European journal of neurology · 2026
Risk of New-Onset Myasthenia Gravis Following COVID-19 Infection and Vaccination: A Population-Based Case-Control Study.
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Kab Tasneem, Pardo Keshet, Hellmann Mark A, Lotan Itay, Friedman Yitzhak, Shochat Tzipora, Wilf-Yarkoni Adi
Аннотация
BACKGROUND: The potential link between myasthenia gravis (MG) and COVID-19 infection or vaccination remains unclear. This study aimed to evaluate the relationship between these factors and new-onset MG.
METHODS: A case-control study was conducted using Clalit Health Services' database. We applied a ML algorithm to reduce diagnostic misclassification. The study examined adults with new onset MG, aged 18 or older, between January 2020 and December 2022 for COVID-19 infection (Cohort I) and between January 2021 and December 2022 for Pfizer-BioNTech COVID-19 vaccine (Cohort II). For each new MG case, three controls matched by age, sex, and index date were selected. Prior exposure to either infection or vaccination was assessed within 90 and 180 days for cases and controls.
RESULTS: In cohort I, 253 new MG cases were identified. A multivariate logistic regression model showed an odds ratio (OR) of 1.44 (95% CI 0.708-2.92) within 90 days post-infection and 1.67 (95% CI 0.98-2.84) within 180 days. In cohort II, 177 new MG cases were detected, with an OR of 1.76 (95% CI 1.049-2.95) within 90 days post-vaccination and 2.45 (95% CI 1.51-3.95) within 180 days.
CONCLUSION: This study suggests no significant increased risk of new-onset MG following COVID-19 infection, but the Pfizer-BioNTech vaccine appears to be associated with a higher risk of developing MG, particularly within 180 days of vaccination.
METHODS: A case-control study was conducted using Clalit Health Services' database. We applied a ML algorithm to reduce diagnostic misclassification. The study examined adults with new onset MG, aged 18 or older, between January 2020 and December 2022 for COVID-19 infection (Cohort I) and between January 2021 and December 2022 for Pfizer-BioNTech COVID-19 vaccine (Cohort II). For each new MG case, three controls matched by age, sex, and index date were selected. Prior exposure to either infection or vaccination was assessed within 90 and 180 days for cases and controls.
RESULTS: In cohort I, 253 new MG cases were identified. A multivariate logistic regression model showed an odds ratio (OR) of 1.44 (95% CI 0.708-2.92) within 90 days post-infection and 1.67 (95% CI 0.98-2.84) within 180 days. In cohort II, 177 new MG cases were detected, with an OR of 1.76 (95% CI 1.049-2.95) within 90 days post-vaccination and 2.45 (95% CI 1.51-3.95) within 180 days.
CONCLUSION: This study suggests no significant increased risk of new-onset MG following COVID-19 infection, but the Pfizer-BioNTech vaccine appears to be associated with a higher risk of developing MG, particularly within 180 days of vaccination.