COVID symptoms, testing, shielding impact on patient reported outcomes and early vaccine responses in individuals with multiple myeloma

ABSTRACT

ObjectiveMultiple myeloma (MM)-related morbidity has a profound effect on quality of life (QoL), and immune function, but few studies have prospectively examined the impact of COVID-19 pandemic and attendant vaccination on both immunity and QoL of patients with MM. We aimed to characterise these effects in a prospective cohort study. DesignWe initiated a prospective national cohort study of patients with MM from start of the second wave of SARS CoV-2 infections in December 2020 and resultant COVID lockdown in the United Kingdom. We assessed current myeloma status, history of COVID19 symptoms, testing and vaccination including response using the rudystudy.org platform. In addition, healthcare resource use, mental and social well being and loneliness (Lubben scale) from the start of the COVID-19 pandemic were assessed. ParticipantsWe report data from the first one hundred and nine adults with MM who completed the questionnaires and the first round of blood testing in the cohort. ResultsFive patients (4.5%) had COVID-19 infection confirmed by history and/or testing (Nucleocapsid antibody). Up to 98% of patients shielded completely or partially during both waves of the pandemic, with 18% of patients consequently changing antimyeloma therapy in the shielding period. Using the Lubben scale, 21/99 (21.2 %) reported social isolation. Using HADS scale 23.1% of patients reported symptoms of mild to moderate anxiety or mild to moderate depression during this period. Humoral immune response (spike ab) tested 3 weeks after first vaccination was detected in 17/28 (60%) patients. ConclusionMyeloma patients shielded during waves of the pandemic with significant change to therapy, low level natural COVID-19 infection (4%) and social isolation. Humoral response following the first dose of COVID-19 vaccine is lower than that reported in non-myeloma cohorts. What is already known on this topicLimited published data exist on the effect of the COVID-19 pandemic on myeloma patients. Post first vaccine response in myeloma patients has been reported in a small number of patients from two studies ranging from 25 % to 56%. What this study addsThis study reports myeloma patients shielded during waves of the pandemic and demonstrates consequent significant social isolation and changes to therapy. Low level natural COVID-19 infection (4%) was noted in the study and humoral response following first dose of COVID-19 vaccine was lower than that reported in non-myeloma cohorts.