The following is a summary of “Sample average treatment effect on the treated (SATT) analysis using counterfactual explanation identifies BMT and SARS-CoV-2 vaccination as protective risk factors associated with COVID-19 severity and survival in patients with multiple myeloma,” published in the December 2023 issue of Oncology by Mitra et al.

The study focused on evaluating risk factors linked to severe COVID-19 outcomes and mortality in individuals diagnosed with multiple myeloma (MM). Leveraging the expansive National COVID Cohort Collaborative (N3C) database, this investigation scrutinized factors associated with adverse clinical indicators such as hospitalization, use of mechanical ventilation, extracorporeal membrane oxygenation (ECMO), and all-cause mortality. Crucial insights were gleaned by examining data from 26,064 MM patients within the N3C consortium, including 8,588 confirmed COVID-19 cases. 

Notably, the mean age at COVID-19 diagnosis was 65.89 years, with 46.8% females and 20.2% of black race. Of these patients, 4.47% experienced mortality within 30 days of hospitalization due to COVID-19. Overall, the survival rate was 90.7% over the study period. The findings highlighted several significant risk factors associated with severe COVID-19 outcomes among MM patients, including histories of pulmonary and renal diseases, treatments such as dexamethasone, proteasome inhibitor (PI), and immunomodulatory (IMiD) therapies, as well as a severe Charlson Comorbidity Index (CCI).

Conversely, protective associations were observed with prior blood-or-marrow transplant (BMT) and COVID-19 vaccination. Moreover, the analysis revealed that elevated CCI levels, moderate or severe International Staging System (ISS) stages, and PI therapy were linked to higher mortality risk. BMT and COVID-19 vaccination correlated with reduced risk of death. Subsequently, utilizing matched sample average treatment effect on the treated (SATT) analysis confirmed the causal impact of BMT and vaccination status as paramount protective factors associated with COVID-19 risks in MM patients across the United States. This extensive nationwide study on MM patients with COVID-19 sheds significant light on the interplay between disease-related factors and COVID-19 outcomes.

Source: nature.com/articles/s41408-023-00901-y