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Multiple Myeloma Diagnosed More via Emergency Care During COVID

The study covered in this summary was published on Research Square as a preprint and has not yet been peer reviewed.

Key Takeaway

  • Patients with multiple myeloma were diagnosed at a significantly higher rate through emergency care during the COVID-19 pandemic compared with before.

Why This Matters

  • While trying to avoid COVID-19 infection, patients ultimately diagnosed with multiple myeloma may have delayed interactions with healthcare professionals and consequently delayed their cancer diagnosis. 

Study Design

  • Researchers collected data on newly diagnosed patients with multiple myeloma from January 2019 until July 2021 across five institutions (three universities and two hospitals) in England. In total, 323 patients with multiple myeloma were identified. 

  • Patients were divided into two groups: those diagnosed between January 1, 2019, until January 31, 2020, or pre-COVID, and those diagnosed from February 1, 2020, until July 31, 2021, or post-COVID.

Key Results

  • Among all patients, 80 (24.8%) were diagnosed with smoldering multiple myeloma and 243 (75.2%) were diagnosed with multiple myeloma requiring treatment.

  • Significantly more patients in the post-COVID group were diagnosed with myeloma through the emergency route (45.5% post-COVID vs 32.7% pre-COVID; P = .03).

  • Clinical complications leading to emergency admission prior to a myeloma diagnosis also differed between the two cohorts: Acute kidney injury accounted for most emergency admissions in the pre-COVID cohort while skeletal-related events, including spinal cord compression, were the major causes for diagnosis through the emergency route in the post-COVID cohort.

  • Patients who were diagnosed with symptomatic myeloma pre-COVID were more likely to be treated with a triplet rather than doublet combination compared with those diagnosed in the post-COVID period (triplet pre-COVID 79.1%, post-COVID 63.75%; P = .014).

  • Overall survival at 1 year was not significantly different between the pre-COVID and post-COVID groups: 88.2% pre-COVID compared with 87.8% post-COVID. 

  • Overall, the authors concluded that the COVID pandemic “resulted in a shift in the symptomatology, disease burden, and routes of diagnosis of patients presenting with myeloma” and “this may have significant consequences” over the long term.


  • Study does not provide a clear timeframe of delays in diagnosis. 


  • Authors did not report any conflicts of interest. 

This is a summary of a preprint research study, “Diagnostic delay in multiple myeloma: the legacy of the COVID-19 pandemic.” The study has not been peer reviewed. The full text can be found at

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