Does a patient with multiple myeloma (not on treatment) and COVID-19 (Coronavirus Disease 2019) with fever require antiviral treatment?

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Last updated: September 21, 2025View editorial policy

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Treatment of COVID-19 in Multiple Myeloma Patients

Patients with multiple myeloma who develop COVID-19 with fever should receive antiviral treatment due to their high-risk immunocompromised status, even if not currently on myeloma treatment. 1, 2

Risk Assessment for Multiple Myeloma Patients with COVID-19

Multiple myeloma patients are at increased risk for severe COVID-19 complications due to:

  • Immunocompromised state from the disease itself
  • Older age (median 69 years in hospitalized MM patients) 3
  • Common comorbidities (renal disease, cardiovascular disease)
  • Higher mortality rates (33% among hospitalized MM patients) 3

Independent predictors of adverse outcomes in MM patients with COVID-19 include:

  • Advanced age
  • High-risk myeloma
  • Renal disease
  • Suboptimal myeloma control (active/progressive disease) 3

Treatment Recommendations

First-line Antiviral Treatment:

  • Nirmatrelvir/ritonavir (Paxlovid) is recommended as first-line therapy for MM patients with COVID-19 and fever 4
    • Dosage: 300 mg nirmatrelvir (two 150 mg tablets) with 100 mg ritonavir twice daily for 5 days
    • Must be started within 5 days of symptom onset
    • Adjust dosing for renal impairment:
      • Moderate impairment (eGFR 30-60 mL/min): 150 mg nirmatrelvir with 100 mg ritonavir twice daily
      • Severe impairment (eGFR <30 mL/min): 300 mg nirmatrelvir with 100 mg ritonavir on day 1, then 150 mg nirmatrelvir with 100 mg ritonavir once daily for days 2-5

Important Considerations:

  • Drug interactions: Carefully review all medications as ritonavir is a strong CYP3A inhibitor 5

    • Consider temporarily pausing interacting medications during the 5-day treatment course
    • Common MM treatments may have significant interactions with ritonavir
  • Alternative options if Paxlovid is contraindicated:

    • Remdesivir (if within 7 days of symptom onset) 1
    • Monoclonal antibodies (if seronegative and variant-susceptible) 1

Management of Multiple Myeloma During COVID-19

  • Temporarily interrupt anti-myeloma treatment until COVID-19 symptoms resolve 6
  • For asymptomatic patients with positive SARS-CoV-2 PCR, consider 14-day quarantine if myeloma status allows treatment delay 6
  • Resume myeloma treatment after clinical resolution and negative PCR test 1

Monitoring and Follow-up

  • Monitor for clinical deterioration: temperature ≥38°C, increasing shortness of breath, tachypnea (>20 breaths/min), hypoxia 2
  • Consider hospitalization for patients with:
    • Oxygen saturation <90%
    • Respiratory rate >30/min
    • Signs of severe disease 1

Special Considerations

  • Despite immunocompromised status, some MM patients can mount effective immune responses against SARS-CoV-2 7
  • Consider immune response assessment to guide decisions about restarting anti-myeloma therapy 7
  • Rare cases of MM remission following COVID-19 have been reported, though this should not influence treatment decisions 8

Prevention Strategies

  • Patient education on personal hygiene and social distancing
  • COVID-19 vaccination (following CDC or local health authority guidelines) 2
  • PCR testing before hospital admission or starting new treatment lines 6
  • Consider telemedicine for stable patients to minimize exposure risk 6

Remember that MM patients with COVID-19 require prompt antiviral treatment regardless of their current myeloma treatment status due to their inherently immunocompromised state and high risk for severe outcomes.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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