Corpus overview


MeSH Disease

Human Phenotype


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

    Authors: Joaquin Martinez-Lopez; Maria-Victoria Mateos; Cristina Encinas; Anna Sureda; Jose Angel Hernandez-Rivas; Ana Lopez de la Guia; Diego Conde; Isabel Krsnik; Elena Prieto; Rosalia Riaza Grau; Mercedes Gironella; Maria Jesus Blanchard; Nerea Caminos; Carlos Fernandez de Larrea; Maria Alicia Senin; Fernando Escalante; Jose Enrique de la Puerta; Eugenio Gimenez; Pilar Martinez-Barranco; Juan Jose Mateos; Luis Felipe Casado; Joan Blade; Juan Jose Lahuerta; Javier De La Cruz; Jesus San-Miguel

    doi:10.1101/2020.06.29.20142455 Date: 2020-06-30 Source: medRxiv

    There is limited information on the characteristics, pre-admission prognostic factors, and outcomes of patients with multiple myeloma HP multiple myeloma MESHD ( MM MESHD) hospitalized with coronavirus disease MESHD 2019 (COVID-19). This retrospective case series investigated characteristics and outcomes of 167 MM MESHD patients hospitalized with COVID-19 reported from 73 hospitals within the Spanish Myeloma MESHD Collaborative Group network in Spain between March 1 and April 30, 2020. Outcomes were compared with a randomly selected contemporary cohort of 167 age TRANS-/sex-matched non-cancer MESHD 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 MESHD patients. Among the MM MESHD and non-cancer MESHD patients, median age TRANS was 71 years and 57% of patients were male TRANS 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 MESHD and non-cancer MESHD patients, respectively, and 21%/9% vs 8%/6% required non-invasive/invasive ventilation. Inpatient mortality was 34% and 23% in MM MESHD and non-cancer MESHD patients, respectively. Among MM MESHD patients, inpatient mortality was 41% in males TRANS, 42% in patients aged TRANS >65 years, 49% in patients with active/progressive MM MESHD at hospitalization, and 59% in patients with comorbid renal disease MESHD 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 MESHD patients hospitalized with COVID-19.

    COVID-19 infections MESHD and outcomes in patients with multiple myeloma HP multiple myeloma MESHD in New York City: a cohort study from five academic centers

    Authors: Malin Hultcrantz; Joshua Richter; Cara Rosenbaum; Dhwani Patel; Eric Smith; Neha Korde; Sydney Lu; Sham Mailankody; Urvi Shah; Alexander Lesokhin; Hani Hassoun; Carlyn Tan; Francesco Maura; Andriy Derkach; Benjamin Diamond; Adriana Rossi; Roger N Pearse; Deppu Madduri; Ajai Chari; David Kaminetzky; Marc Braunstein; Christian Gordillo; Faith Davies; Sundar Jagannath; Ruben Niesvizky; Suzanne Lentzsch; Gareth Morgan; Ola Landgren

    doi:10.1101/2020.06.09.20126516 Date: 2020-06-11 Source: medRxiv

    Importance: New York City is a global epicenter for the SARS-CoV-2 outbreak with a significant number of individuals infected by the virus. Patients with multiple myeloma HP multiple myeloma MESHD have a compromised immune system, due to both the disease and anti- myeloma MESHD therapies, and may therefore be particularly susceptible to coronavirus disease MESHD 2019 (COVID-19); however, there is limited information to guide clinical management. Objective: To assess risk factors and outcomes of COVID-19 in patients with multiple myeloma HP multiple myeloma MESHD. Design: Case-series. Setting: Five large academic centers in New York City. Participants: Patients with multiple myeloma HP multiple myeloma MESHD and related plasma SERO cell disorders who were diagnosed with COVID-19 between March 10th, 2020 and April 30th, 2020. Exposures: Clinical features and risk factors were analyzed in relation to severity of COVID-19. Main Outcomes and Measures: Descriptive statistics as well as logistic regression were used to estimate disease severity reflected in hospital admissions, intensive care unit (ICU) admission, need for mechanical ventilation, or death MESHD. Results: Of 100 multiple myeloma HP multiple myeloma MESHD patients ( male TRANS 58%; median age TRANS 68, range 41-91) diagnosed with COVID-19, 74 (74%) were admitted; of these 13 (18%) patients were placed on mechanical ventilation, and 18 patients (24%) expired. None of the studied risk factors were significantly associated (P>0.05) with adverse outcomes (ICU-admission, mechanical ventilation, or death MESHD): hypertension HP hypertension MESHD (N=56) odds ratio (OR) 2.3 (95% confidence interval [CI] 0.9-5.9); diabetes MESHD (N=18) OR 1.1 (95% CI 0.3-3.2); age TRANS >65 years (N=63) OR 2.0 (95% CI 0.8-5.3); high dose melphalan with autologous stem cell transplant <12 months (N=7) OR 1.2 (95% CI 0.2-7.4), IgG<650 mg/dL (N=42) OR=1.2 (95% CI 0.4-3.1). In the entire series of 127 patients with plasma SERO cell disorders, hypertension HP hypertension MESHD was significantly associated with the combined end-point (OR 3.4, 95% CI 1.5-8.1). Conclusions and Relevance: Although multiple myeloma HP myeloma MESHD patients have a compromised immune system due to both the disease and therapy; in this largest disease specific cohort to date of patients with multiple myeloma HP multiple myeloma MESHD and COVID-19, compared to the general population, we found risk factors for adverse outcome to be shared and mortality rates to be within the higher range of officially reported mortality rates.

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

    Authors: Bo Wang; Oliver Van Oekelen; Tarek Mouhieddine; Diane Marie Del Valle; Joshua Richter; Hearn Jay Cho; Shambavi Richard; Ajai Chari; Sacha Gnjatic; Miriam Merad; Sundar Jagannath; Samir Parekh; Deepu Madduri

    doi:10.1101/2020.06.04.20122846 Date: 2020-06-05 Source: medRxiv

    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 impacted cancer MESHD patients and the organization of cancer MESHD care. Mount Sinai Hospital has a large and diverse multiple myeloma HP myeloma MESHD ( MM MESHD) population. Herein, we report the characteristics of COVID-19 infection MESHD and serological response in MM MESHD 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 SERO-cell disorder (54 MM MESHD, 4 smoldering MM MESHD) 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 SERO 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 TRANS was 67 years; 52% of patients were male TRANS and 63% were non-white. Hypertension HP Hypertension MESHD (64%), hyperlipidemia HP hyperlipidemia MESHD (62%), obesity HP obesity MESHD (37%), diabetes mellitus HP diabetes mellitus MESHD (28%), chronic kidney disease HP chronic kidney disease MESHD (24%) and lung disease MESHD (21%) were the most common comorbidities. In the total cohort, 14 patients (24%) died. Older age TRANS (>70 years), male TRANS 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 MESHD, non-white race, and mortality. Ninety-six percent (22/23) of patients developed antibodies to SARS-CoV-2 SERO 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 MESHD 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 MESHD were associated with higher mortality. The majority of patients mounted an antibody SERO response to SARS-CoV-2. These findings pave a path to identification of vulnerable MM MESHD patients who need early intervention to improve outcome in future outbreaks of COVID-19.

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MeSH Disease
Human Phenotype

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