scholarly journals COVID-19 infections and outcomes in patients with multiple myeloma in New York City: a cohort study from five academic centers

Author(s):  
Malin Hultcrantz ◽  
Joshua Richter ◽  
Cara Rosenbaum ◽  
Dhwani Patel ◽  
Eric Smith ◽  
...  

AbstractImportanceNew York City is a global epicenter for the SARS-CoV-2 outbreak with a significant number of individuals infected by the virus. Patients with multiple myeloma have a compromised immune system, due to both the disease and anti-myeloma therapies, and may therefore be particularly susceptible to coronavirus disease 2019 (COVID-19); however, there is limited information to guide clinical management.ObjectiveTo assess risk factors and outcomes of COVID-19 in patients with multiple myeloma.DesignCase-series.SettingFive large academic centers in New York City.ParticipantsPatients with multiple myeloma and related plasma cell disorders who were diagnosed with COVID-19 between March 10th, 2020 and April 30th, 2020.ExposuresClinical features and risk factors were analyzed in relation to severity of COVID-19.Main Outcomes and MeasuresDescriptive statistics as well as logistic regression were used to estimate disease severity reflected in hospital admissions, intensive care unit (ICU) admission, need for mechanical ventilation, or death.ResultsOf 100 multiple myeloma patients (male 58%; median age 68, range 41-91) diagnosed with COVID-19, 74 (74%) were admitted; of these 13 (18%) patients were placed on mechanical ventilation, and 18 patients (24%) expired. None of the studied risk factors were significantly associated (P>0.05) with adverse outcomes (ICU-admission, mechanical ventilation, or death): hypertension (N=56) odds ratio (OR) 2.3 (95% confidence interval [CI] 0.9-5.9); diabetes (N=18) OR 1.1 (95% CI 0.3-3.2); age >65 years (N=63) OR 2.0 (95% CI 0.8-5.3); high dose melphalan with autologous stem cell transplant <12 months (N=7) OR 1.2 (95% CI 0.2-7.4), IgG<650 mg/dL (N=42) OR=1.2 (95% CI 0.4-3.1). In the entire series of 127 patients with plasma cell disorders, hypertension was significantly associated with the combined end-point (OR 3.4, 95% CI 1.5-8.1).Conclusions and RelevanceAlthough multiple myeloma patients have a compromised immune system due to both the disease and therapy; in this largest disease specific cohort to date of patients with multiple myeloma and COVID-19, compared to the general population, we found risk factors for adverse outcome to be shared and mortality rates to be within the higher range of officially reported mortality rates.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wil Lieberman-Cribbin ◽  
Naomi Alpert ◽  
Raja Flores ◽  
Emanuela Taioli

Abstract Background New York City (NYC) was the epicenter of the COVID-19 pandemic, and is home to underserved populations with higher prevalence of chronic conditions that put them in danger of more serious infection. Little is known about how the presence of chronic risk factors correlates with mortality at the population level. Here we determine the relationship between these factors and COVD-19 mortality in NYC. Methods A cross-sectional study of mortality data obtained from the NYC Coronavirus data repository (03/02/2020–07/06/2020) and the prevalence of neighborhood-level risk factors for COVID-19 severity was performed. A risk index was created based on the CDC criteria for risk of severe illness and complications from COVID-19, and stepwise linear regression was implemented to predict the COVID-19 mortality rate across NYC zip code tabulation areas (ZCTAs) utilizing the risk index, median age, socioeconomic status index, and the racial and Hispanic composition at the ZCTA-level as predictors. Results The COVID-19 death rate per 100,000 persons significantly decreased with the increasing proportion of white residents (βadj = − 0.91, SE = 0.31, p = 0.0037), while the increasing proportion of Hispanic residents (βadj = 0.90, SE = 0.38, p = 0.0200), median age (βadj = 3.45, SE = 1.74, p = 0.0489), and COVID-19 severity risk index (βadj = 5.84, SE = 0.82, p <  0.001) were statistically significantly positively associated with death rates. Conclusions Disparities in COVID-19 mortality exist across NYC and these vulnerable areas require increased attention, including repeated and widespread testing, to minimize the threat of serious illness and mortality.


Author(s):  
Desmond Sutton ◽  
Timothy Wen ◽  
Anna P. Staniczenko ◽  
Yongmei Huang ◽  
Maria Andrikopoulou ◽  
...  

Objective This study was aimed to review 4 weeks of universal novel coronavirus disease 2019 (COVID-19) screening among delivery hospitalizations, at two hospitals in March and April 2020 in New York City, to compare outcomes between patients based on COVID-19 status and to determine whether demographic risk factors and symptoms predicted screening positive for COVID-19. Study Design This retrospective cohort study evaluated all patients admitted for delivery from March 22 to April 18, 2020, at two New York City hospitals. Obstetrical and neonatal outcomes were collected. The relationship between COVID-19 and demographic, clinical, and maternal and neonatal outcome data was evaluated. Demographic data included the number of COVID-19 cases ascertained by ZIP code of residence. Adjusted logistic regression models were performed to determine predictability of demographic risk factors for COVID-19. Results Of 454 women delivered, 79 (17%) had COVID-19. Of those, 27.9% (n = 22) had symptoms such as cough (13.9%), fever (10.1%), chest pain (5.1%), and myalgia (5.1%). While women with COVID-19 were more likely to live in the ZIP codes quartile with the most cases (47 vs. 41%) and less likely to live in the ZIP code quartile with the fewest cases (6 vs. 14%), these comparisons were not statistically significant (p = 0.18). Women with COVID-19 were less likely to have a vaginal delivery (55.2 vs. 51.9%, p = 0.04) and had a significantly longer postpartum length of stay with cesarean (2.00 vs. 2.67days, p < 0.01). COVID-19 was associated with higher risk for diagnoses of chorioamnionitis and pneumonia and fevers without a focal diagnosis. In adjusted analyses, including demographic factors, logistic regression demonstrated a c-statistic of 0.71 (95% confidence interval [CI]: 0.69, 0.80). Conclusion COVID-19 symptoms were present in a minority of COVID-19-positive women admitted for delivery. Significant differences in obstetrical outcomes were found. While demographic risk factors demonstrated acceptable discrimination, risk prediction does not capture a significant portion of COVID-19-positive patients. Key Points


2007 ◽  
Vol 84 (2) ◽  
pp. 212-225 ◽  
Author(s):  
Susan E. Manning ◽  
Lorna E. Thorpe ◽  
Chitra Ramaswamy ◽  
Anjum Hajat ◽  
Melissa A. Marx ◽  
...  

2021 ◽  
pp. 003335492110075
Author(s):  
Claudia Chernov ◽  
Lisa Wang ◽  
Lorna E. Thorpe ◽  
Nadia Islam ◽  
Amy Freeman ◽  
...  

Objectives Immigrant adults tend to have better health than native-born adults despite lower incomes, but the health advantage decreases with length of residence. To determine whether immigrant adults have a health advantage over US-born adults in New York City, we compared cardiovascular disease (CVD) risk factors among both groups. Methods Using data from the New York City Health and Nutrition Examination Survey 2013-2014, we assessed health insurance coverage, health behaviors, and health conditions, comparing adults ages ≥20 born in the 50 states or the District of Columbia (US-born) with adults born in a US territory or outside the United States (immigrants, following the National Health and Nutrition Examination Survey) and comparing US-born adults with (1) adults who immigrated recently (≤10 years) and (2) adults who immigrated earlier (>10 years). Results For immigrant adults, the mean time since arrival in the United States was 21.8 years. Immigrant adults were significantly more likely than US-born adults to lack health insurance (22% vs 12%), report fair or poor health (26% vs 17%), have hypertension (30% vs 23%), and have diabetes (20% vs 11%) but significantly less likely to smoke (18% vs 27%) (all P < .05). Comparable proportions of immigrant adults and US-born adults were overweight or obese (67% vs 63%) and reported CVD (both 7%). Immigrant adults who arrived recently were less likely than immigrant adults who arrived earlier to have diabetes or high cholesterol but did not differ overall from US-born adults. Conclusions Our findings may help guide prevention programs and policy efforts to ensure that immigrant adults remain healthy.


2021 ◽  
Author(s):  
Kiran Thakur ◽  
Victoria T. Chu ◽  
Christine Hughes ◽  
Carla Y. Kim ◽  
Shannon Fleck-Dardarian ◽  
...  

Author(s):  
Jyoti S Mathad ◽  
Myung Hee Lee ◽  
Andrea Chalem ◽  
Melissa K Frey ◽  
Eloise Chapman-Davis ◽  
...  

Abstract We evaluated sex-related differences in symptoms and risk factors for mortality in 4798 patients hospitalized with Covid-19 in New York City. When adjusted for age and comorbidities, being male was an independent predictor of death with mortality significantly higher than females, even with low SARS-CoV-2 viral load at admission.


2020 ◽  
Vol 1 (3) ◽  
pp. 234-243 ◽  
Author(s):  
Malin Hultcrantz ◽  
Joshua Richter ◽  
Cara A. Rosenbaum ◽  
Dhwani Patel ◽  
Eric L. Smith ◽  
...  

Epidemiology ◽  
2004 ◽  
Vol 15 (4) ◽  
pp. S146-S147
Author(s):  
Parisa Tehranifar ◽  
Andrew Faciano ◽  
Howard Alper ◽  
Andrea Paykin ◽  
Jessica Leighton

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