COVID-19 and Myeloma: Continuity of Care in Italian Tertiary Hospital
Posted: Tuesday, August 11, 2020
According to research published in Blood Advances, early adoption of stringent preventive measures is essential to safely and effectively care for patients with multiple myeloma and other blood disorders during the COVID-19 pandemic. Widescale use of personal protective equipment, sequestration of hematologic wards, comprehensive collection of patients’ symptoms and contacts, social distancing, staggered appointments, and increased use of telemedicine practices were among the recommended interventions.
“This would limit the spread of the infection among patients and workers, ensure the continuity of care, and allow the delivery of life-saving therapies/transfusions to urgent patients with aggressive diseases,” concluded Luca Baldini, MD, of the University of Milan, and colleagues.
The study included 4,750 patients from a medical facility in Lombardy, Italy, during the first 6 weeks of the COVID-19 pandemic, many of whom had multiple myeloma or other hematologic diseases. Clinical services decreased by roughly 10% over the first 2 weeks of the study, remained steady for the following 2 weeks, and decreased by 17% in the final 2 weeks. Outpatient visits decreased by a median of 48% between weeks 1 and 6, as all nonurgent appointments (n = 44) were deferred. Staff progressively scaled up their use of personal protective equipment, from surgical masks and latex gloves to double masks, eye goggles, and disposable outerwear.
The hematology/transplant ward was sectioned off from the internal medicine ward, and some hematology personnel were reassigned to COVID-19 wards, and telecommuting was implemented for many personnel. The outpatient waiting room was reorganized to facilitate social distancing. Temperature scans and symptoms/contact lists were required for entry, and all who were symptomatic were tested for COVID-19. As of April 5, 2020, 26 patients had tested positive, 2 of whom had multiple myeloma. Overall, 22 of 26 were hospitalized, with 4 admitted to the intensive care unit. Six patients discontinued hematologic medications, and six patients died.
Disclosure: The study authors reported no conflicts of interest.