High risk of hypoxemic COVID-19 pneumonia in myasthenia gravis patients with type I IFN autoantibodies.

We studied an international cohort of 85 unvaccinated SARS-CoV-2-infected myasthenia gravis patients not given antiviral treatment.

Six (16.2%) of the remaining 37 patients had AAN-I-IFN, neutralizing both IFN-α2 and IFN-ω in three patients.

The risk of producing AAN-I-IFN was much higher in myasthenia gravis patients than in the general population (OR [95% CI]: 28.9 [10.8 to 77.7], P = 4.9 × 10 -27 ).

Thymoma was found in 14 patients and increased the risk of AAN-I-IFN (64% versus 27%, (OR [95% CI]: 5.6 [1.6 to 19.4], P = 0.0050) and hypoxemic pneumonia (9.2 [1.9 to 44.2]; P = 0.0019).