Vaccination and Antiviral Combination Improves Resolution Time of COVID-19 Infection in Treated Multiple Myeloma: A Retrospective Study

The COVID-19 pandemic posed significant challenges for patients with hematological malignancies, including multiple myeloma (MM), who experienced increased hospitalization and mortality rates due to frailty and immune suppression. This retrospective, multicenter study aimed to evaluate the impact of antiviral therapies and COVID-19 vaccination doses on clinical outcomes in 206 symptomatic MM patients undergoing active treatment across five Italian regions. The majority (90%) received at least one vaccine dose, and 61% were treated with antiviral agents (nirmatrelvir/ritonavir, molnupiravir, or remdesivir). Of the cohort, 90% were vaccinated, with 89% receiving ≥ 3 doses, and 61% received antiviral agents (nirmatrelvir/ritonavir, molnupiravir, or remdesivir). Patients vaccinated with ≥ 3 doses showed significantly reduced infection severity (p = 0.044), hospitalization rates (p = 0.008), and infection resolution time (p = 0.037). Unvaccinated patients without antiviral therapy had a significantly higher mortality rate (p = 0.004). Antiviral therapy, especially when combined with ≥ 3 vaccine doses, further shortened infection resolution time (p = 0.011) but did not significantly affect hospitalization rates or disease severity. This study highlights the critical role of ≥ 3 vaccine doses combined with antiviral therapy in improving COVID-19 outcomes in MM patients, with a reduced infection duration and lower progression to severe disease. Further investigation is required to optimize treatment strategies in this vulnerable population.