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A tertiary center experience of multiple myeloma patients with COVID-19: lessons learned and the path forward.
Wang, Bo; Van Oekelen, Oliver; Mouhieddine, Tarek H; Del Valle, Diane Marie; Richter, Joshua; Cho, Hearn Jay; Richard, Shambavi; Chari, Ajai; Gnjatic, Sacha; Merad, Miriam; Jagannath, Sundar; Parekh, Samir; Madduri, Deepu.
  • Wang B; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 10 East 102nd Street, 6th Floor, New York, NY, 10029, USA.
  • Van Oekelen O; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 10 East 102nd Street, 6th Floor, New York, NY, 10029, USA.
  • Mouhieddine TH; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
  • Del Valle DM; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 10 East 102nd Street, 6th Floor, New York, NY, 10029, USA.
  • Richter J; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 10 East 102nd Street, 6th Floor, New York, NY, 10029, USA.
  • Cho HJ; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 10 East 102nd Street, 6th Floor, New York, NY, 10029, USA.
  • Richard S; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 10 East 102nd Street, 6th Floor, New York, NY, 10029, USA.
  • Chari A; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 10 East 102nd Street, 6th Floor, New York, NY, 10029, USA.
  • Gnjatic S; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 10 East 102nd Street, 6th Floor, New York, NY, 10029, USA.
  • Merad M; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 10 East 102nd Street, 6th Floor, New York, NY, 10029, USA.
  • Jagannath S; Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
  • Parekh S; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 10 East 102nd Street, 6th Floor, New York, NY, 10029, USA.
  • Madduri D; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 10 East 102nd Street, 6th Floor, New York, NY, 10029, USA.
J Hematol Oncol ; 13(1): 94, 2020 07 14.
Article in English | MEDLINE | ID: covidwho-647080
Preprint
This scientific journal article is probably based on a previously available preprint. It has been identified through a machine matching algorithm, human confirmation is still pending.
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ABSTRACT

BACKGROUND:

The COVID-19 pandemic, caused by SARS-CoV-2 virus, has resulted in over 100,000 deaths in the USA. Our institution has treated over 2000 COVID-19 patients during the pandemic in New York City. The pandemic directly impacted cancer patients and the organization of cancer care. Mount Sinai Hospital has a large and diverse multiple myeloma (MM) population. Herein, we report the characteristics of COVID-19 infection and serological response in MM patients in a large tertiary care institution in New York.

METHODS:

We performed a retrospective study on a cohort of 58 patients with a plasma-cell disorder (54 MM, 4 smoldering MM) who developed COVID-19 between March 1, 2020, and April 30, 2020. We report epidemiological, clinical, and laboratory characteristics including the persistence of viral detection by polymerase chain reaction (PCR) and anti-SARS-CoV-2 antibody testing, treatments initiated, and outcomes.

RESULTS:

Of the 58 patients diagnosed with COVID-19, 36 were hospitalized and 22 were managed at home. The median age was 67 years; 52% of patients were male and 63% were non-White. Hypertension (64%), hyperlipidemia (62%), obesity (37%), diabetes mellitus (28%), chronic kidney disease (24%), and lung disease (21%) were the most common comorbidities. In the total cohort, 14 patients (24%) died. Older age (> 70 years), male sex, cardiovascular risk, and patients not in complete remission (CR) or stringent CR were significantly (p < 0.05) associated with hospitalization. Among hospitalized patients, laboratory findings demonstrated elevation of traditional inflammatory markers (CRP, ferritin, D-dimer) and a significant (p < 0.05) association between elevated inflammatory markers, severe hypogammaglobulinemia, non-White race, and mortality. Ninety-six percent (22/23) of patients developed antibodies to SARS-CoV-2 at a median of 32 days after initial diagnosis. The median time to PCR negativity was 43 (range 19-68) days from initial positive PCR.

CONCLUSIONS:

Drug exposure and MM disease status at the time of contracting COVID-19 had no bearing on mortality. Mounting a severe inflammatory response to SARS-CoV-2 and severe hypogammaglobulinemia was associated with higher mortality. The majority of patients mounted an antibody response to SARS-CoV-2. These findings pave a path to the identification of vulnerable MM patients who need early intervention to improve outcomes in future outbreaks of COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Tertiary Care Centers / Betacoronavirus / Multiple Myeloma Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: J Hematol Oncol Journal subject: Hematology / Neoplasms Year: 2020 Document Type: Article Affiliation country: S13045-020-00934-x

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Tertiary Care Centers / Betacoronavirus / Multiple Myeloma Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: J Hematol Oncol Journal subject: Hematology / Neoplasms Year: 2020 Document Type: Article Affiliation country: S13045-020-00934-x