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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality 58% Improvement Relative Risk Aspirin for COVID-19  Wang et al.  Prophylaxis Is prophylaxis with aspirin beneficial for COVID-19? Retrospective 58 patients in the USA Lower mortality with aspirin (not stat. sig., p=0.43) c19early.org Wang et al., J. Hematology & Oncology, Jul 2020 Favors aspirin Favors control

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

Wang et al., Journal of Hematology & Oncology, doi:10.1186/s13045-020-00934-x
Jul 2020  
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Aspirin for COVID-19
24th treatment shown to reduce risk in August 2021
 
*, now known with p = 0.000087 from 73 studies, recognized in 2 countries.
Lower risk for mortality and progression.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments. c19early.org
Retrospective 58 multiple myeloma COVID-19 patients in the USA, showing no significant difference with aspirin treatment.
Study covers aspirin and metformin.
risk of death, 57.7% lower, RR 0.42, p = 0.43, treatment 1 of 9 (11.1%), control 13 of 49 (26.5%), NNT 6.5, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Wang et al., 14 Jul 2020, retrospective, USA, peer-reviewed, 13 authors.
This PaperAspirinAll
A tertiary center experience of multiple myeloma patients with COVID-19: lessons learned and the path forward
Bo Wang, Oliver Van Oekelen, Tarek H Mouhieddine, Diane Marie Del Valle, Joshua Richter, Hearn Jay Cho, Shambavi Richard, Ajai Chari, Sacha Gnjatic, Miriam Merad, Sundar Jagannath, Samir Parekh, Deepu Madduri
Journal of Hematology & Oncology, doi:10.1186/s13045-020-00934-x
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.
Supplementary information Supplementary information accompanies this paper at https://doi.org/10. 1186/s13045-020-00934-x. Additional file 1: Figure S1 . Evolution of selected inflammatory biomarkers in a subset of patients (n = 12) hospitalized at the Mount Sinai Hospital for which the data was available. Different measurements from the same patient are connected. A linear regression line is plotted for the subgroup of patients that survived (blue, n = 8) and died (red, n = 4), respectively. Abbreviations Funding There is no outside funding declared for this study. Ethics approval and consent to participate This study was performed in accordance with the Declaration of Helsinki and International Conference on Harmonization Guidelines for Good Clinical Practice (IRB: GCO#: 11-1433). Consent for publication Not applicable. Author details Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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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. 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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. 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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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