Survival in multiple myeloma and SARS‐COV‐2 infection through the COVID‐19 pandemic: Results from the EPICOVIDEHA registry
Authors: Musto Pellegrino , Salmanton‐García Jon , Sgherza Nicola , Bergantim Rui , Farina Francesca , Glenthøj Andreas , Cengiz Seval Guldane , Weinbergerová Barbora , Bonuomo Valentina , Bilgin Yavuz M. , van Doesum Jaap , Jaksic Ozren , Víšek Benjamín , Falces‐Romero Iker , Marchetti Monia , Dávila‐Valls Julio , Martín‐Pérez Sonia , Nucci Marcio , López‐García Alberto , Itri Federico , Buquicchio Caterina , Verga Luisa , Piukovics Klára , Navrátil Milan , Collins Graham P. , Jiménez Moraima , Fracchiolla Nicola S. , Labrador Jorge , Prezioso Lucia , Rossi Elena , Čolović Natasha , Meers Stef , Kulasekararaj Austin , Cuccaro Annarosa , Blennow Ola , Valković Toni , Sili Uluhan , Ledoux Marie‐Pierre , Batinić Josip , Passamonti Francesco , Machado Marina , Duarte Rafael F. , Poulsen Christian Bjørn , Méndez Gustavo‐Adolfo , Espigado Ildefonso , Demirkan Fatih , Čerňan Martin , Cattaneo Chiara , Petzer Verena , Magliano Gabriele , Garcia‐Vidal Carolina , El‐Ashwah Shaimaa , Gomes‐Da‐Silva Maria , Vena Antonio , Ormazabal‐Vélez Irati , van Praet Jens , Dargenio Michelina , De‐Ramón Cristina , Del Principe Maria Ilaria , Marques‐De‐Almeida Joyce , Wolf Dominik , Szotkowski Tomáš , Obr Aleš , Çolak Gökçe Melis , Nordlander Anna , Izuzquiza Macarena , Cabirta Alba , Zambrotta Giovanni Paolo Maria , Cordoba Raul , Žák Pavel , Ammatuna Emanuele , Mayer Jiří , Ilhan Osman , García‐Sanz Ramón , Quattrone Martina , Arellano Elena , Nunes‐Rodrigues Raquel , Emarah Ziad , Aiello Tommaso Francesco , Hanakova Michaela , Ráčil Zdeněk , Bavastro Martina , Limongelli Alessandro , Rahimli Laman , Marchesi Francesco , Cornely Oliver A. , Pagano Livio 
Published: December 2023

Patients affected by multiple myeloma (MM) have an increased risk of severe acute respiratory syndrome coronavirus type 2 (SARS‐CoV‐2) infection and subsequent coronavirus (20)19 disease (COVID‐19)‐related death. The changing epidemiological and therapeutic scenarios suggest that there has been an improvement in severity and survival of COVID‐19 during the different waves of the pandemic in the general population, but this has not been investigated yet in MM patients. Here we analyzed a large cohort of 1221 patients with MM and confirmed SARS‐CoV‐2 infection observed between February 2020, and August 2022, in the EPICOVIDEHA registry from 132 centers around the world. Median follow‐up was 52 days for the entire cohort and 83 days for survivors. Three‐hundred and three patients died (24%) and COVID‐19 was the primary reason for death of around 89% of them. Overall survival (OS) was significantly higher in vaccinated patients with both stable and active MM versus unvaccinated, while only a trend favoring vaccinated patients was observed in subjects with responsive MM. Vaccinated patients with at least 2 doses showed a better OS than those with one or no vaccine dose. Overall, according to pandemic waves, mortality rate decreased over time from 34% to 10%. In multivariable analysis, age, renal failure, active disease, hospital, and intensive care unit admission, were independently associated with a higher number of deaths, while a neutrophil count above 0.5 × 109/L was found to be protective. This data suggests that MM patients remain at risk of SARS‐CoV‐2 infection even in the vaccination era, but their clinical outcome, in terms of OS, has progressively improved throughout the different viral phases of the pandemic.