Multiple Myeloma and SARS-CoV-2 Infection: Clinical Characteristics and Prognostic Factors of Inpatient Mortality

Abstract

There is limited information on the characteristics, pre-admission prognostic factors, and outcomes of patients with multiple myeloma (MM) hospitalized with coronavirus disease 2019 (COVID-19). This retrospective case series investigated characteristics and outcomes of 167 MM patients hospitalized with COVID-19 reported from 73 hospitals within the Spanish Myeloma Collaborative Group network in Spain between March 1 and April 30, 2020. Outcomes were compared with a randomly selected contemporary cohort of 167 age-/sex-matched non-cancer patients with COVID-19 admitted at 6 participating hospitals. Common demographic, clinical, laboratory, treatment, and outcome variables were collected; specific disease status and treatment data were collected for MM patients. Among the MM and non-cancer patients, median age was 71 years and 57% of patients were male in each series, and 75% and 77% of patients, respectively, had at least one comorbidity. COVID-19 clinical severity was moderate-severe in 77% and 89% of patients and critical in 8% and 4%, respectively. Supplemental oxygen was required by 47% and 55% of MM and non-cancer patients, respectively, and 21%/9% vs 8%/6% required non-invasive/invasive ventilation. Inpatient mortality was 34% and 23% in MM and non-cancer patients, respectively. Among MM patients, inpatient mortality was 41% in males, 42% in patients aged >65 years, 49% in patients with active/progressive MM at hospitalization, and 59% in patients with comorbid renal disease at hospitalization, which were independent prognostic factors of inpatient mortality on adjusted multivariate analysis. This case series demonstrates the increased risk and identifies predictors of inpatient mortality among MM patients hospitalized with COVID-19.

Clinical features associated with COVID-19 outcome in multiple myeloma: first results from the International Myeloma Society data set

“…Our data suggests higher mortality in hospitalized patients with MM and COVID-19 infection than non-myeloma patients. A recent study from Spain found higher mortality rate in MM patients with COVID-19 (34%) compared to age and sex matched non-MM patients with COVID-19 (23%) 21 . A recent publication from France confirmed overall mortality in all hospitalized patients with COVID-19 to be 16%, which is significantly lower then mortality observed in hospitalized MM patients in France (39%) 22 .…”

Mortality in patients with cancer and coronavirus disease 2019: A systematic review and pooled analysis of 52 studies

“…[ 26 ] Preprint 181 60 30 Apr to 26 May 2020 Brazilian National Cancer Institute Any 19 Martinez-Lopez et al. [ 27 ] Preprint 167 56 1 Mar to 30 Apr 2020 73 hospitals in Spain Multiple myeloma only 20 Russel et al. [ 28 ] Preprint 156 34 29 Feb to 12 May 2020 Guys Hospital, London, UK Any 21 Basse et al.…”

Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study

“…We did not collect data on contacts although during the first wave of the COVID-19 pandemic in Madrid, we expected most patients to be infected by community transmission. Finally, our case series incorporates a heterogeneous patient population with multiple different hematologic malignancies; further studies in patients with specific malignancies [32] are needed, as it is possible that type of malignancy and disease status may affect the clinical course of COVID-19. Nevertheless, our study included a large number of patients with some malignancies, which could overcome in part this perceived limitation.…”