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A tertiary center experience of multiple myeloma patients with COVID-19: lessons learned and the path forward.

Title: A tertiary center experience of multiple myeloma patients with COVID-19: lessons learned and the path forward.
Authors: Wang, Bo; Wang, Bo; Van Oekelen, Oliver; Mouhieddine, Tarek; Del Valle, Diane; Richter, Joshua; Cho, Hearn; Richard, Shambavi; Chari, Ajai; Gnjatic, Sacha; Merad, Miriam; Jagannath, Sundar; Parekh, Samir; Madduri, Deepu
Source: Journal of Hematology & Oncology; vol 13, iss 1
Publisher Information: eScholarship, University of California 2020-07-14
Document Type: Electronic Resource
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. CO
Index Terms: COVID-19; Multiple myeloma; New York; Pandemic; SARS; SARS-Cov-2; Smoldering multiple myeloma; Agammaglobulinemia; Aged; Betacoronavirus; Cohort Studies; Coronavirus Infections; Female; Humans; Immunocompromised Host; Inflammation; Male; Middle Aged; Multiple Myeloma; New York City; Pandemics; Pneumonia; Viral; Retrospective Studies; Risk Factors; SARS-CoV-2; Tertiary Care Centers; article
URL: https://escholarship.org/uc/item/4fx5n6nw; https://escholarship.org/content/qt4fx5n6nw/qt4fx5n6nw.pdf
Availability: Open access content. Open access content; public
Note: application/pdf; Journal of Hematology & Oncology vol 13, iss 1
Other Numbers: CDLER oai:escholarship.org:ark:/13030/qt4fx5n6nw; qt4fx5n6nw; https://escholarship.org/uc/item/4fx5n6nw; https://escholarship.org/content/qt4fx5n6nw/qt4fx5n6nw.pdf; info:doi/10.1186/s13045-020-00934-x; https://escholarship.org/; 1464625527
Contributing Source: UC MASS DIGITIZATION; From OAIster®, provided by the OCLC Cooperative.
Accession Number: edsoai.on1464625527
Database: OAIster