Thromboembolic events, including venous thromboembolism (VTE) and arterial thromboembolism (ATE), and mortality from subclinical thrombotic events occur frequently in coronavirus disease 2019 (COVID-19) inpatients. Whether the risk extends postdischarge has been controversial. Our prospective registry included consecutive patients with COVID-19 hospitalized within our multihospital system from 1 March to 31 May 2020. We captured demographics, comorbidities, laboratory parameters, medications, postdischarge thromboprophylaxis, and 90-day outcomes. Data from electronic health records, health informatics exchange, radiology database, and telephonic follow-up were merged. Primary outcome was a composite of adjudicated VTE, ATE, and all-cause mortality (ACM). Principal safety outcome was major bleeding (MB). Among 4906 patients (53.7% male), mean age was 61.7 years. Comorbidities included hypertension (38.6%), diabetes (25.1%), obesity (18.9%), and cancer history (13.1%). Postdischarge thromboprophylaxis was prescribed in 13.2%. VTE rate was 1.55%; ATE, 1.71%; ΑCM, 4.83%; and MB, 1.73%. Composite primary outcome rate was 7.13% and significantly associated with advanced age (odds ratio [OR], 3.66; 95% CI, 2.84-4.71), prior VTE (OR, 2.99; 95% CI, 2.00-4.47), intensive care unit (ICU) stay (OR, 2.22; 95% CI, 1.78-2.93), chronic kidney disease (CKD; OR, 2.10; 95% CI, 1.47-3.0), peripheral arterial disease (OR, 2.04; 95% CI, 1.10-3.80), carotid occlusive disease (OR, 2.02; 95% CI, 1.30-3.14), IMPROVE-DD VTE score ≥4 (OR, 1.51; 95% CI, 1.06-2.14), and coronary artery disease (OR, 1.50; 95% CI, 1.04-2.17). Postdischarge anticoagulation was significantly associated with reduction in primary outcome (OR, 0.54; 95% CI, 0.47-0.81). Postdischarge VTE, ATE, and ACM occurred frequently after COVID-19 hospitalization. Advanced age, cardiovascular risk factors, CKD, IMPROVE-DD VTE score ≥4, and ICU stay increased risk. Postdischarge anticoagulation reduced risk by 46%.

Background: Myotonic dystrophy type 2 (DM2) is a recently discovered adult muscular dystrophy. Similar to DM1, this disease causes progressive debilitating weakness, clinical myotonia, and early cataracts and is thought to cause widespread physiologic dysfunction of multiple organ systems. Objective: To analyze and compile the laboratory abnormalities of patients with DM2. Design: Baseline DM2 laboratory data were compiled representing 68 different types of laboratory tests and 1442 total studies. Setting: University medical center. Patients: Eighty-three adults with genetically confirmed or clinically probable DM2 were identified. Of these patients, 49 had documented baseline laboratory screening. Main Outcome Measures: The individual frequencies of abnormal laboratory values in the population with DM2 studied.Results: Of the 1442 studies, results for 359 (24.9%) were outside of their standard reference ranges. Of the 68 types of laboratory tests studied, 43 had values from 15 or more different patients with DM2. The relative frequency of an abnormally elevated laboratory value was greater than 50% in several tests, including the levels of creatine kinase, total cholesterol, lactate dehydrogenase, and alanine aminotransferase. In addition, serum levels of IgG were low in 75% of all patients with DM2 tested, and absolute lymphocyte counts were low in 54% of all patients with DM2 tested. Conclusions:There is a high frequency of laboratory abnormalities in patients with DM2. These abnormalities provide insight into the widespread pathologic manifestations of DM2 and may form a basis for clinical monitoring and disease screening.

Objective: The global COVID-19 pandemic has posed a major challenge for patients with hematological malignancies undergoing treatment. For patients with acute leukemia and aggressive lymphomas, delaying curative chemotherapy treatments has historically been associated with adverse outcomes. In the absence of any quality prospective data, expert recommendation has been to treat when possible. Though earlier studies have reported that cancer patients are at an increased risk for mortality due to COVID-19 when compared to the general population, questions remain unanswered as to how specific agents used to treat malignancies affect the natural history of COVID-19. In particular, the effect of anti-CD20 therapy in patients with lymphoid malignancies remains unexplored in patients who contract COVID-19 during their treatment. Methods: We conducted a retrospective chart review of patients at our New York-based institution to identify any COVID-19 positive patients that required inpatient treatment for their lymphoid malignancy from December 31st, 2019 to July 31st, 2020. Only patients that had received anti-CD20 therapy (rituximab or obinutuzumab) were included in this study. COVID-19 positivity was determined via a positive PCR-based test (either nasopharyngeal swab or bronchoalveolar lavage). Results: A total of 13 patients were identified, with primary hematological diagnoses including DLBCL (6), ALL (1), MALT lymphoma (1), follicular lymphoma (2), and chronic lymphocytic leukemia (1). The COVID-19 related mortality rate in this cohort was 46% (6), with the remainder recovering from COVID-19. Of the 7 patients who survived, 2 patients had persistently positive COVID-19 PCR-based testing after clinical recovery, 2 failed to develop detectable IgG anti-COVID-19 antibodies, 1 had not had antibody testing, and 2 had detectable antibodies. Of the 2 patients that developed antibodies after recovery, 1 had undetectable anti-COVID-19 IgG levels 55 days later on subsequent testing. Conclusions: Patients who are hospitalized with lymphoid malignancies and are requiring anti-CD20 therapy seem to be at increased risk of COVID-19-related mortality. Furthermore, anti-CD20 therapy appears to adversely impact the development of IgG antibodies and appears to be associated with delayed clearance of the virus on PCR-based testing. Disclosures Saif: Lexicon: Research Funding; Yivia: Research Funding; NGM Bio.: Research Funding; Nouscom: Research Funding; ITA Group: Other: Teaching Engagement, Travel Compesation; UpToDate: Patents & Royalties: Royalties; Merck Sharp & Dohme Corporation: Honoraria; Incyte: Research Funding.

e18626 Background: Pts with malignancies are at risk for developing severe complications of COVID-19 with high mortality rate. We retrospectively analyzed COVID-19 related outcomes for hospitalized pts with SMs. Methods: We collected data on hospitalized pts with SMs and COVID-19 from 3/1/20 to Jan 1/1/21. Diagnosis COVID-19 was confirmed by RT-PCR of nasopharyngeal swabs. We assessed the association between the 30-day mortality and potential prognostic variables such as tumor types, cancer status, timing of treatment, types of anticancer therapy using logistic regression analyses. Results: A total of 246 hospitalized pts with SMs had COVID-19. Median age was 70 years, 87 (35%) were ≥75 years, 151 (61%) were female. The most common SMs were breast (56 [23%]), non-small cell lung (44 [18%]) and colon (31 [13%]). 154 (63%) pts were on active anticancer therapies. Of those 88 (35.5%) received treatment within 2 weeks, 16 (16.5%) within 4-12 weeks, 99 (39.9%) >3 months prior to COVID-19 diagnosis. 101 (65%) pts received cytotoxic chemotherapies, 26 (16.8%) received immune check point inhibitors (ICIs), 17 (11%) received targeted agents such as anti-EGFR therapy and 11 (7.1%) received monoclonal antibodies. Overall 30-day mortality was 42%, however, all pts with melanoma (7/7) died. The 30-day mortalities for pts who received anticancer treatments within 4 weeks, 4-12 weeks and >12 weeks of COVID-19 diagnosis were 47%, 50%, and 37%. For pts who never received treatment, 30-day mortality was 31%. For pts were in remission, stable disease and progressive disease, the 30-day mortalities were 32%, 35% and 62%. The 30-day mortalities for pts who received cytotoxic therapy, monoclonal antibodies, targeted therapies and ICIs, were 38%, 46%, 41% and 69%. Logistic regression analysis showed that pts who were >80 years of age (OR 3.6, 95% CI 1.6-8.1), had progressive disease (OR 3.4, 95% CI 1.8-6.5) or treated with ICIs (OR 3.6, 95% CI 1.5-8.7) were associated with higher 30-day mortality. Conclusions: COVID-19 associated 30-day mortality is high for hospitalized pts with SMs. Early surveillance of clinical deterioration could be helpful for hospitalized SMs pts with risk factors identified here. Further studies are needed to discern the observed association between ICIs use and worse COVID-19 outcome.[Table: see text]