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

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	A tertiary center experience of multiple myeloma patients with COVID-19: lessons learned and the path forward
Creator	Wang, Bo Merad, Miriam Chari, Ajai Cho, Hearn Del Valle, Diane Gnjatic, Sacha Jagannath, Sundar Madduri, Deepu Mouhieddine, Tarek Parekh, Samir Richard, Shambavi Richter, Joshua Van Oekelen, Oliver
source	MedRxiv; Medline; PMC
abstract	BACKGROUND: The COVID-19 pandemic, caused by SARS-CoV-2 virus, has resulted in over 100,000 deaths in the United States. Our institution has treated over 2,000 COVID-19 patients during the pandemic in New York City. The pandemic directly impacts cancer patients and the organization of cancer care. Mount Sinai Hospital has a large and diverse multiple myeloma population. Here, we report the characteristics of COVID-19 infection and serological response in multiple myeloma (MM) patients in a large tertiary care institution in New York. METHODS: We performed a retrospective study of 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 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 (CKD, 24%) and lung disease (21%) were the most common comorbidities. In the total cohort, 14 patients (24%) died. Older age (>70 years), male sex and cardiovascular risk 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. Median time to PCR negativity was 43 (range 19-68) days from initial positive PCR. CONCLUSIONS: Drug exposure and MM disease status at the time of contracting COVID-19 had no bearing on patient outcome. Mounting a severe inflammatory response to SARS-CoV-2, and severe hypogammaglobulinemia were associated with higher mortality. These findings pave a path to identification of vulnerable patients who need early intervention to improve outcome of myeloma patients in future outbreaks of COVID-19. The majority of myeloma patients mounted a specific antibody response to SARS-CoV-2.
has issue date	2020-06-05(xsd:dateTime)
bibo:doi	10.1101/2020.06.04.20122846
bibo:pmid	32577702
has license	cc-by-nc-nd
schema:url	https://doi.org/10.1101/2020.06.04.20122846
resource representing a document's title	A tertiary center experience of multiple myeloma patients with COVID-19: lessons learned and the path forward
has PubMed Central identifier	PMC7302311
has PubMed identifier	32577702
schema:publication	medRxiv
resource representing a document's body	covid:PMC7302311#body_text
is schema:about of	named entity 'patients' named entity 'lessons learned' named entity 'EXPERIENCE' named entity 'PATIENTS' named entity 'COVID-19' named entity 'myeloma' named entity 'direct oral anticoagulant' named entity 'IL-6' named entity 'cytokine release syndrome' named entity 'New York City' named entity 'light chain' named entity 'interquartile range' named entity 'demographic characteristics' named entity 'immunosuppressive' named entity 'public health crisis' named entity 'hypogammaglobulinemia' named entity 'transaminases' named entity 'SARS-CoV-2' named entity 'Hispanic' named entity 'beta blockers' named entity 'COVID' named entity 'interleukin (IL)-6' named entity 'high-risk' named entity 'SARS-CoV-2' named entity 'diabetes mellitus type 2' named entity 'IL-6' named entity 'nursing records' named entity 'cancer center' named entity 'serum' named entity 'death rates' named entity 'demographic data' named entity 'New York' named entity 'SARS-CoV-2' named entity 'CAR' named entity 'follow-up' named entity 'dyspnea' named entity 'endothelial' named entity 'mortality rates' named entity 'COVID' named entity 'statistically significant' named entity 'ng/mL' named entity 'infection' named entity 'mortality rate' named entity 'nasal cannula' named entity 'remdesivir' named entity 'ASCT' named entity 'nasal cannula' named entity 'PCR' named entity 'fever' named entity 'IL-6' named entity 'COVID' named entity 'COVID' named entity 'SARS-CoV-2' named entity 'infection' named entity 'COVID' named entity 'death rate' named entity 'mechanical ventilation' named entity '16,000' named entity 'United States' named entity 'beats per minute' named entity 'IRB' named entity 'epidemiology' named entity 'COVID' named entity 'retrospective study' named entity 'univariate analysis' named entity 'leukopenia' named entity 'continuous positive airway pressure' named entity 'COVID-19' named entity 'virus' named entity 'titer'

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