Contributions
Abstract: PB1659
Type: Publication Only
Session title: Myeloma and other monoclonal gammopathies - Clinical
Background
The Sars-CoV-2 pandemic has markedly disrupted haemato-oncology services in the UK in balancing Covid-19 infection risk with MM management. New light has been shed on risk factors for mortality in hospitalised Covid-19 patients with concurrent MM. However, reported mortality rates for Covid-19 in MM patients show significant heterogeneity between countries, and do not examine for changes to mortality despite huge shifts in Covid-19 management throughout the pandemic.
Aims
1) Record patient demographics and medical risk factors of all MM patients hospitalised with Covid-19 between March 2020 to January 2021 in the NCA (catchment population of ~1,000,000 patients), UK.
2) Compare patient factors and outcomes between the first and second wave of the Sars-CoV-2 pandemic to characterise more currently reflective demographic and outcome data for Covid-19 in MM patients.
Methods
All patients with a previous diagnosis of MM who were admitted Covid-19 treatment were included. Covid-19 diagnosis was defined as a positive nasopharyngeal PCR swab 7 days before or after admission. Admissions during the 01/03/2020 to 30/06/2020 and 01/07/2020 to 07/01/2021 were included, and classified as the first and second wave, respectively. Patient demographics, myeloma therapy before admission, medical co-morbidities, and 28-day mortality from Covid-19 test positivity was recorded and analysed. Statistical comparison of mortality rate was applied between the first and second wave.
Results
6 patients were admitted in the first wave of whom 6 (100%) died. 6 patients were admitted in the second wave, of whom 2 (33.3%) died. The change in mortality between waves approached, but fell short of, statistical significance (p=0.061). The average age in both waves was 79 and both had heterogeneous but comparable medical co-morbidities. Gender did not correlate to mortality, and gender ratios were comparable between both groups. 10 of 12 patients had medical therapy for MM prior to their admission, 7 of which were bortezomib based, two lenalidomide-Ixazomib based, and one receiving pomalidomide monotherapy. No correlation was detected between specific MM therapy or therapy line, on pandemic wave or mortality.
Conclusion
This study seeks to define more up to date Covid-19 outcomes in MM patients compared to previous outcome data which uses both early and current Covid-19 outcome data, homogenously. Our findings are strictly limited by sample size and power but display a large difference in Covid-19 mortality rate between the first and second wave in the NCA. Due to comparable patient and medical characteristics, and near statistical significance, these findings suggest a significant reduction in mortality of Covid-19 in MM patients between the first and second Sars-CoV-2 wave in the UK and is a novel finding which warrants further study to confirm or refute this. A more representative set of outcome statistics for Covid-19 infection in MM patients would represent today’s pandemic and may shed light on the impact of previously implemented changes in MM management as well as advances in Covid-19 inpatient care. Finally, an accurate representation of today’s Covid-19 outcomes in MM patients would set the benchmark for comparing interventional outcomes going forward.
Keyword(s):
Abstract: PB1659
Type: Publication Only
Session title: Myeloma and other monoclonal gammopathies - Clinical
Background
The Sars-CoV-2 pandemic has markedly disrupted haemato-oncology services in the UK in balancing Covid-19 infection risk with MM management. New light has been shed on risk factors for mortality in hospitalised Covid-19 patients with concurrent MM. However, reported mortality rates for Covid-19 in MM patients show significant heterogeneity between countries, and do not examine for changes to mortality despite huge shifts in Covid-19 management throughout the pandemic.
Aims
1) Record patient demographics and medical risk factors of all MM patients hospitalised with Covid-19 between March 2020 to January 2021 in the NCA (catchment population of ~1,000,000 patients), UK.
2) Compare patient factors and outcomes between the first and second wave of the Sars-CoV-2 pandemic to characterise more currently reflective demographic and outcome data for Covid-19 in MM patients.
Methods
All patients with a previous diagnosis of MM who were admitted Covid-19 treatment were included. Covid-19 diagnosis was defined as a positive nasopharyngeal PCR swab 7 days before or after admission. Admissions during the 01/03/2020 to 30/06/2020 and 01/07/2020 to 07/01/2021 were included, and classified as the first and second wave, respectively. Patient demographics, myeloma therapy before admission, medical co-morbidities, and 28-day mortality from Covid-19 test positivity was recorded and analysed. Statistical comparison of mortality rate was applied between the first and second wave.
Results
6 patients were admitted in the first wave of whom 6 (100%) died. 6 patients were admitted in the second wave, of whom 2 (33.3%) died. The change in mortality between waves approached, but fell short of, statistical significance (p=0.061). The average age in both waves was 79 and both had heterogeneous but comparable medical co-morbidities. Gender did not correlate to mortality, and gender ratios were comparable between both groups. 10 of 12 patients had medical therapy for MM prior to their admission, 7 of which were bortezomib based, two lenalidomide-Ixazomib based, and one receiving pomalidomide monotherapy. No correlation was detected between specific MM therapy or therapy line, on pandemic wave or mortality.
Conclusion
This study seeks to define more up to date Covid-19 outcomes in MM patients compared to previous outcome data which uses both early and current Covid-19 outcome data, homogenously. Our findings are strictly limited by sample size and power but display a large difference in Covid-19 mortality rate between the first and second wave in the NCA. Due to comparable patient and medical characteristics, and near statistical significance, these findings suggest a significant reduction in mortality of Covid-19 in MM patients between the first and second Sars-CoV-2 wave in the UK and is a novel finding which warrants further study to confirm or refute this. A more representative set of outcome statistics for Covid-19 infection in MM patients would represent today’s pandemic and may shed light on the impact of previously implemented changes in MM management as well as advances in Covid-19 inpatient care. Finally, an accurate representation of today’s Covid-19 outcomes in MM patients would set the benchmark for comparing interventional outcomes going forward.
Keyword(s):