P-1913. Characteristics, Clinical Management, and Outcomes of Leukemia, Lymphoma and Multiple Myeloma Patients Hospitalized with a Primary Diagnosis of COVID-19: Insights from Hospitals across the United States
Authors: Mozaffari Essy , Chandak Aastha , Chima-Melton Chidinma , Kalil Andre , Berry Mark , Jiang Heng , Bartoletti Michele , Loubet Paul 
Published: January 2025

Abstract

Background
Immunocompromised (IC) patients remain at high risk of hospitalizations, complications, and mortality due to COVID-19. However, limited information is available on specific IC conditions. We describe patient characteristics, clinical management of patients with leukemia, lymphoma or multiple myeloma hospitalized for COVID-19.Table 1:Characteristics of Leukemia, Lymphoma and Multiple Myeloma patients hospitalized for COVID-19

Methods
Using the PINC AI Healthcare database, patients with leukemia, lymphoma or multiple myeloma hospitalised during Jan’22-Dec’23 with a primary discharge diagnosis of COVID-19 were examined. Patient characteristics were described for the three IC conditions. Utilization of COVID-19 treatments by supplemental oxygen requirements and outcomes of in-hospital mortality, all-cause and COVID-19 related readmission were assessed.
Figure 1: COVID-19 treatments by supplemental oxygen requirements during the hospitalization

Results
During the study period, 2356 leukemia, 2249 lymphoma and 1178 multiple myeloma patients were hospitalized with a primary diagnosis of COVID-19. During the hospitalization, around a third required low-flow oxygen, one-fifth high-flow oxygen/non-invasive ventilation and 7-8% invasive mechanical ventilation. Further, mortality rates were 17%, 21% and 16% and COVID-19 related readmission rates were 11%, 14% and 7% for the leukemia, lymphoma and multiple myeloma patients, respectively (Table 1).
Half of the patients received remdesivir across all levels of oxygenation and &gt;90% received corticosteroids among those requiring supplemental oxygen. Further, use of corticosteroid monotherapy was observed in a third of the patients requiring any supplemental oxygen, and in a quarter not requiring supplemental oxygen. A quarter of the patients without supplemental oxygen did not receive any COVID-19 treatment (Fig 1).

Conclusion
The study highlights the high mortality and readmission rates faced by the high-risk IC patients with underlying conditions of leukemia, lymphoma or multiple myeloma hospitalized for COVID-19. Almost half did not receive antiviral treatment with remdesivir despite being hospitalized with a primary diagnosis of COVID-19, while a third received corticosteroid monotherapy contradicting guideline recommendations. Further, about a quarter without supplemental oxygen did not receive any COVID-19 treatment despite established effectiveness of remdesivir in this group.

Disclosures
Essy Mozaffari, PharmD, MPH, MBA, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds (Public Company) Aastha Chandak, PhD, Gilead Sciences Inc.: My organization (Certara) was contracted by Gilead to conduct this study Chidinma Chima-Melton, MD, Gilead Sciences: Advisor/Consultant Mark Berry, PhD, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds (Public Company) Heng Jiang, MS, MPH, Gilead Sciences Inc.: My organization (Certara) was contracted by Gilead to conduct this study Michele Bartoletti, MD, PhD, Advan pharma: Advisor/Consultant|Advan pharma: Honoraria|Biomereux: Honoraria|Gilead: Advisor/Consultant|Gilead: Honoraria|Infectopharma: Advisor/Consultant|Msd: Advisor/Consultant|Msd: Grant/Research Support|Msd: Honoraria|Pfizer: Honoraria Paul LOUBET, MD, PhD, Astrazeneca: Advisor/Consultant|Gilead: Advisor/Consultant|Moderna: Advisor/Consultant|Pfizer: Advisor/Consultant