COVID-19 FAQ #5 What are the risk factors that could lead myeloma patients to develop serious consequences from the COVID-19 infection?
The fifth episode of his ten episode COVID-19 FAQ series, Dr. Brian G.M. Durie discusses which factors increase a myeloma patient's risk for developing serious consequences from the COVID-19 Infection.
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Videos in the COVID-19 Series
- FAQ #1: How can myeloma pts reduce the possibility of being exposed to the coronavirus?
- FAQ #2: What do myeloma patients need to know about COVID-19?
- FAQ #3: Do myeloma patients need to adjust their treatment?
- FAQ #4: What are some of the treatment modifications myeloma patients should consider?
- FAQ #5: What are the risk factors that could lead myeloma patients to develop serious consequences from the COVID-19 infection?
- FAQ #6: What precautions should myeloma patients take when getting their groceries?
- FAQ #7: Is it safe for myeloma patients to take walks?
- FAQ #8: Is physical distancing still recommended for myeloma patients?
- FAQ #9: Can myeloma patients avoid contracting the COVID-19 infection?
- FAQ #10: Should Myeloma patients undergo routine COVID-19 antibody testing?
- FAQ #11: Are MGUS and smoldering multiple myeloma (SMM) patients considered to be at higher risk for severe consequences from a COVID-19 infection?
- FAQ #12: If a myeloma patient takes Revlimid® (lenalidomide) as maintenance treatment, should this patient continue with that treatment during the pandemic?
- FAQ #13: Is it safe for myeloma patients to resume in-person doctors' visits?
This “Ask Dr. Durie” is one of the frequently asked questions with regard to the COVID-19 infection. This is FAQ number 5, and this is a very important question that relates to, “what are the risk factors for developing more serious consequences if an individual becomes infected with the COVID-19 virus?”
And the first thing to say is that not all myeloma patients are necessarily at the highest risk. But under some circumstances, there is a definite important high risk for patients with myeloma.
These situations are, number one, at the time of initial diagnosis and early induction therapy, when there is a risk of medical complications, particularly, infection. Following on with that, autologous stem cell transplant is a definite risk factor right now, and is something that really needs to be avoided, because there is a two to three week period where there is engraftment of the stem cells and when the blood counts are low, and this is a particularly dangerous time when COVID-19 infection could cause a variety of medical issues. The third situation is at a point of relapse, where new therapy is required. And again, this is an unstable period where COVID-19 infection could cause particular problems. And so, under those circumstances, there is a need for particular caution to avoid exposure.
Other risk factors to be aware of are related to age, for any individual over the age of seventy, there is an increased risk for more serious consequences. For some reason, men are at more serious risk than women of having lung issues and other medical complications.
Other factors are things that we call comorbidities or other diseases which an individual might have. The ones which have caused the most trouble in cases from Asia, and more recently in Europe and in the U.S., are individuals who have diabetes, individuals who are overweight or are frankly, obese, individuals who have chronic lung disease, chronic kidney disease, or ongoing cardiovascular disease, particularly, high blood pressure. Patients with high blood pressure seem to be at a particular risk for complications.
Other things to be considered for patients with myeloma is that if a patient is elderly and more frail with reduced physical performance status, this puts them at risk for having more serious issues.
The BOTTOM LINE is that obviously all myeloma patients do need to be particularly cautious. However, a patient who is in remission, perhaps a VGPR or a complete remission and is doing well is not necessarily at the highest risk. And, some of these other comorbidities and other factors are things that are to be the most concerned about. And, no matter what, the top priority for all myeloma patients is to try as hard as possible to avoid exposure.
Dr. Brian G.M. Durie serves as Chairman of the International Myeloma Foundation and serves on its Scientific Advisory Board. Additionally, he is Chairman of the IMF's International Myeloma Working Group, a consortium of nearly 200 myeloma experts from around the world. Dr. Durie also leads the IMF’s Black Swan Research Initiative®.