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

{ 'indexed': {'date-parts': [[2024, 4, 2]], 'date-time': '2024-04-02T06:38:28Z', 'timestamp': 1712039908806}, 'reference-count': 39, 'publisher': 'Springer Science and Business Media LLC', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2020, 7, 14]], 'date-time': '2020-07-14T00:00:00Z', 'timestamp': 1594684800000}, 'content-version': 'tdm', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}, { 'start': { 'date-parts': [[2020, 7, 14]], 'date-time': '2020-07-14T00:00:00Z', 'timestamp': 1594684800000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}], 'content-domain': {'domain': ['link.springer.com'], 'crossmark-restriction': False}, 'published-print': {'date-parts': [[2020, 12]]}, 'abstract': '<jats:title>Abstract</jats:title><jats:sec>\n' '<jats:title>Background</jats:title>\n' '<jats:p>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.</jats:p>\n' '</jats:sec><jats:sec>\n' '<jats:title>Methods</jats:title>\n' '<jats:p>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.</jats:p>\n' '</jats:sec><jats:sec>\n' '<jats:title>Results</jats:title>\n' '<jats:p>Of the 58 patients diagnosed with COVID-19, 36 were hospitalized and 22 were managed ' 'at home. The median age was 67\u2009years; 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 (&gt; 70\u2009years), male sex, cardiovascular ' 'risk, and patients not in complete remission (CR) or stringent CR were significantly ' '(<jats:italic>p</jats:italic> &lt; 0.05) associated with hospitalization. Among hospitalized ' 'patients, laboratory findings demonstrated elevation of traditional inflammatory markers ' '(CRP, ferritin, D-dimer) and a significant (<jats:italic>p</jats:italic> &lt; 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\u2009days after initial diagnosis. The median time to PCR ' 'negativity was 43 (range 19–68) days from initial positive PCR.</jats:p>\n' '</jats:sec><jats:sec>\n' '<jats:title>Conclusions</jats:title>\n' '<jats:p>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.</jats:p>\n' '</jats:sec>', 'DOI': '10.1186/s13045-020-00934-x', 'type': 'journal-article', 'created': {'date-parts': [[2020, 7, 14]], 'date-time': '2020-07-14T13:38:34Z', 'timestamp': 1594733914000}, 'update-policy': 'http://dx.doi.org/10.1007/springer_crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 94, 'title': 'A tertiary center experience of multiple myeloma patients with COVID-19: lessons learned and the ' 'path forward', 'prefix': '10.1186', 'volume': '13', 'author': [ {'given': 'Bo', 'family': 'Wang', 'sequence': 'first', 'affiliation': []}, {'given': 'Oliver', 'family': 'Van Oekelen', 'sequence': 'additional', 'affiliation': []}, {'given': 'Tarek H.', 'family': 'Mouhieddine', 'sequence': 'additional', 'affiliation': []}, {'given': 'Diane Marie', 'family': 'Del Valle', 'sequence': 'additional', 'affiliation': []}, {'given': 'Joshua', 'family': 'Richter', 'sequence': 'additional', 'affiliation': []}, {'given': 'Hearn Jay', 'family': 'Cho', 'sequence': 'additional', 'affiliation': []}, {'given': 'Shambavi', 'family': 'Richard', 'sequence': 'additional', 'affiliation': []}, {'given': 'Ajai', 'family': 'Chari', 'sequence': 'additional', 'affiliation': []}, {'given': 'Sacha', 'family': 'Gnjatic', 'sequence': 'additional', 'affiliation': []}, {'given': 'Miriam', 'family': 'Merad', 'sequence': 'additional', 'affiliation': []}, {'given': 'Sundar', 'family': 'Jagannath', 'sequence': 'additional', 'affiliation': []}, {'given': 'Samir', 'family': 'Parekh', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-7305-9690', 'authenticated-orcid': False, 'given': 'Deepu', 'family': 'Madduri', 'sequence': 'additional', 'affiliation': []}], 'member': '297', 'published-online': {'date-parts': [[2020, 7, 14]]}, 'reference': [ { 'key': '934_CR1', 'unstructured': 'Richardson S, Hirsch JS, Narasimhan M, et al. 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S. J.: Advisory board and consulting ' 'fees from Celgene, Bristol-Myers Squibb, Janssen Pharmaceuticals and Merck. H. ' 'J. C: Employed by the Multiple Myeloma Research Foundation, advisory board and ' 'consulting fees from Genetech, Celgene, Bristol Myers Squibb, GlaxoSmithKline ' 'and received research funding from Takeda, Celgene, and Genetech. D. M.: ' 'Advisory board and consulting fees from Janssen, Celgene, Bristol Myers Squibb, ' 'Takeda, Legend, GlaxoSmithKline, Kinevant, and Foundation Medicine. B.W.: ' 'Consulting fees from Sanofi Genzyme. J. R.: Speaking fees from Celgene and ' 'Janssen, advisory board and consulting fees from Celgene, Janssen, Bristol ' 'Myers Squibb, Oncopeptides, Adaptive Biotechnologies, X4 Pharmaceuticals, ' 'Karyopharm, and Antegene. S. P.: Consulting fees from Foundation Medicine, ' 'research funding from Celgene and Karyopharm, supported by 1R01CA244899-01A1. ' 'All other authors declare no potential conflict of interest<b>.</b>', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Competing interests'}}], 'article-number': '94'}