COVID-19 Infections and Clinical Outcomes in Patients with Multiple Myeloma in New York City: A Cohort Study from Five Academic Centers
COVID-19 Infections and Clinical Outcomes in Patients with Multiple Myeloma in New York City: A Cohort Study from Five Academic Centers
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DOI：
10.1101/2020.06.09.20126516
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发表时间：
2020-11-01
影响因子：
11.2
通讯作者：
Landgren, Ola
中科院分区：
文献类型：
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作者：
Hultcrantz, Malin;Richter, Joshua;Landgren, Ola
多发性骨髓瘤患者的免疫系统受到疾病和抗骨髓瘤治疗的双重影响，因此可能特别容易感染COVID-19。在这里，我们报告了2020年春季在纽约市五个大型学术中心治疗的多发性骨髓瘤患者的严重疾病的结果和危险因素，在此期间，纽约市是SARS-CoV-2大流行的全球中心。在100例诊断为COVID-19的多发性骨髓瘤患者（男性58%，中位年龄68岁）中，75例入院；其中13例（17%）患者接受有创机械通气，22例（29%）患者死亡。25例未入院患者中，4例无症状。与白人患者（n= 36）相比，西班牙裔/拉丁裔（n= 21）和非裔美国黑人（n= 33）的不良结局（重症监护病房入院、机械通气或死亡）的风险更高，or = 4.7(95%可信区间，1.3-16.7),or = 3.5（1.1-11.5）。达到不良联合终点的患者总体上有较高水平的炎症标志物和细胞因子激活。其他研究的危险因素与不良结局均无显著相关（P < 0.05）：高血压（n = 56）， OR = 2.2 (0.9-5.4)；糖尿病（n = 18）， OR = 0.9 (0.3-2.9)；年龄0 ~ 65岁（n= 63）， OR =1.8 (0.7 ~ 4.6)；大剂量美法仑与自体干细胞移植
Patients with multiple myeloma have a compromised immune system, due to both the disease and antimyeloma therapies, and may therefore be particularly susceptible to COVID-19. Here, we report outcomes and risk factors for serious disease in patients with multiple myeloma treated at five large academic centers in New York City in the spring of 2020, during which it was a global epicenter of the SARS-CoV-2 pandemic. Of 100 patients with multiple myeloma (male 58%; median age 68) diagnosed with COVID-19, 75 were admitted; of these, 13 patients (17%) were placed on invasive mechanical ventilation, and 22 patients (29%) expired. Of the 25 nonadmitted patients, 4 were asymptomatic. There was a higher risk of adverse outcome (intensive care unit admission, mechanical ventilation, or death) in Hispanics/Latinos (n = 21), OR = 4.7 (95% confidence interval, 1.3-16.7), and African American Blacks (n= 33), OR= 3.5 (1.1-11.5), as compared with White patients (n= 36). Patients who met the adverse combined endpoint had overall higher levels of inflammatory markers and cytokine activation. None of the other studied risk factors were significantly associated (P > 0.05) with adverse outcome: hypertension (n = 56), OR = 2.2 (0.9-5.4); diabetes (n = 18), OR = 0.9 (0.3-2.9); age >65 years (n= 63), OR =1.8 (0.7-4.6); high-dose melphalan with autologous stem cell transplant