Abstract
The COVID-19 pandemic has represented a major cause of morbidity/mortality worldwide, overstressing health systems. Multiple myeloma (MM) patients show an increased risk for infections and they are expected to be particularly vulnerable to SARS-CoV-2 infection. Here we have obtained a comprehensive picture of the impact of COVID-19 in MM patients on a local and a global scale using a federated data research network (TriNetX) that provided access to Electronic Medical Records (EMR) from Health Care Organizations (HCO) all over the world. Through propensity score matched analyses we found that the number of new diagnoses of MM was reduced in 2020 compared to 2019 (RR 0.86, 95%CI 0.76–0.96) and the survival of newly diagnosed MM cases decreased similarly (HR 0.61, 0.38–0.81). MM patients showed higher risk of SARS-CoV-2 infection (RR 2.09, 1.58–2.76) and a higher excess mortality in 2020 (difference in excess mortality 9%, 4.4–13.2) than non-MM patients. By interrogating large EMR datasets from HCO in Europe and globally, we confirmed that MM patients have been more severely impacted by COVID-19 pandemic than non-MM patients. This study highlights the necessity of extending preventive measures worlwide to protect vulnerable patients from SARS-CoV-2 infection by promoting social distancing and an intensive vaccination strategies.
Highlights
Since its outbreak at the end of 2019, the coronavirus disease 2019 (COVID-19) has overstretched National Health Systems (NHS) worldwide and had a profound impact on healthcare quality and access [1,2,3]
The Hospital 12 de Octubre network (H12O) cohort had a total number of 417 patients, mean age of 67.4 years and 196 (47%) males; EMEA had a total number of 3738 patients, mean age of 69.4 and 2119 (57%) males, and Global had a total number of 43 192 patients, mean age of Patient flowchart and characteristics
The survival of COVID-19 non-MM patients increased in the second period: 89.41% (703) vs 96.21% (252), hazard ratio 2.64 (2.29–3.05), p < 0.001 in H12O; 88.10% (2059) vs 90.94% (1569), hazard ratio 1.25 (1.17–1.34), p < 0.001 in EMEA. In this real-world data analysis, we showed that diagnosis of new MM cases has decreased during the COVID-19 pandemic at a local and global level
Summary
Since its outbreak at the end of 2019, the coronavirus disease 2019 (COVID-19) has overstretched National Health Systems (NHS) worldwide and had a profound impact on healthcare quality and access [1,2,3]. The risk of infection is increased in MM patients, and it is a major cause of morbidity and mortality [13,14,15,16]. Recent studies have shown that viruses represent a frequent etiology of infections in MM patients [17, 18]. Multicenter and international clinical studies have documented that patients with MM are a vulnerable population at high risk of hospitalization and death following a COVID-19 infection [19,20,21,22,23]. There are no data evaluating whether MM patients are at increased risk of infection by SARS-CoV-2 compared with the overall population
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