MM-219: Outcome of COVID-19 Among Patients with Multiple Myeloma at the Armenian Hematology Center

Abstract

The effect of COVID-19 on patients with multiple myeloma (MM), the second most common hematological malignancy, is of particularly great concern due to immunosuppression associated with the disease, and at this time remains incompletely understood. The aim of the current study was the analysis of the characteristics of COVID-19 infection and serological response in MM patients in Armenia for the period of 2020-2021.MethodsWe performed a retrospective study (epidemiological, clinical, and laboratory characteristics) on a cohort of 125 patients with MM, 42 in which developed COVID-19 between March 1, 2020, and May 30, 2021.ResultsOf the 42 (33.6%) patients diagnosed with COVID-19, 19 (45.2%) were hospitalized and 23 (66.4%) were managed at home. The median age was 60 years; 40.5% of patients were male. Hypertension (39%), hyperlipidemia (42%), obesity (33%), diabetes mellitus (18%), chronic kidney disease (14%), and lung disease (18%) were the most common comorbidities. In the total cohort, 8 patients (19%) died. The most common initial symptoms were fever (63%), cough (50%), dyspnea (43%), and hypoxemia (28%). Clinical status was considered as mild in 24 (57%), severe in 10 (24%), or critical in 8 (19%), with lung infiltrates reported on imaging in 12 (29%) and multiple organ failure in 4 (10%). Older age, male sex, cardiovascular risk, and patients with noncomplete remission were significantly (p<0.02) associated with hospitalization. Among hospitalized patients, laboratory findings demonstrated elevation of traditional inflammatory markers and a significant (p<0.01) association between elevated inflammatory markers, severe hypogammaglobulinemia and mortality. Hospitalization was required in 16 patients for a median of 10-12 days (range, 3–32), 2 needing mechanical ventilation. Most patients required O2 administration, in addition to antibiotics and hydroxychloroquine.ConclusionOur limited experience of COVID-19 emphasizes the severity of this condition in MM patients, with a high mortality incidence (19%). However, based on these preliminary data, in a country where about 62 new MM are diagnosed each year and where 222 000 cases of COVID-19 have been reported so far, this complication remains very rare. Further investigations are mandatory in order to assess the impact of this new viral infection on MM patients.