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Monoclonal gammopathy of undetermined significance and COVID-19 : a population-based cohort study

Monoclonal gammopathy of undetermined significance and COVID-19 : a population-based cohort study

Title: Monoclonal gammopathy of undetermined significance and COVID-19 : a population-based cohort study
Author: Rögnvaldsson, Sæmundur
Eythorsson, Elias
Thorsteinsdottir, Sigrun
Vidarsson, Brynjar
Önundarson, Páll Torfi
Agnarsson, Bjarni Agnar
Sigurdardottir, Margret
Thorsteinsdóttir, Ingunn
Ólafsson, Ísleifur
Runólfsdóttir, Hrafnhildur L.
... 19 more authors Show all authors
Date: 2021-12-01
Language: English
Scope: 1082673
Department: Internal Medicine and Emergency Services
Faculty of Medicine
Clinical Laboratory Services, Diagnostics and Blood Bank
Other departments
Perioperative Services
Women's and Childrens's Services
Faculty of Nursing and Midwifery
Office of Division of Clinical Services II
Office of Division of Clinical Services I
Cancer Center
Series: Blood Cancer Journal; 11(12)
ISSN: 2044-5385
DOI: 10.1038/s41408-021-00580-7
Subject: COVID-19; Ónæmiskerfi; Mergæxli; Adult; Aged; COVID-19/epidemiology; Cohort Studies; Female; Humans; Iceland/epidemiology; Male; Middle Aged; Monoclonal Gammopathy of Undetermined Significance/epidemiology; Risk Factors; SARS-CoV-2; Hematology; Oncology
URI: https://hdl.handle.net/20.500.11815/2990

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Rögnvaldsson , S , Eythorsson , E , Thorsteinsdottir , S , Vidarsson , B , Önundarson , P T , Agnarsson , B A , Sigurdardottir , M , Thorsteinsdóttir , I , Ólafsson , Í , Runólfsdóttir , H L , Helgason , D , Emilsdóttir , A R , Ágústsson , A S , Björnsson , A H , Kristjánsdóttir , G , Thordardottir , A R , Indridason , O S , Jónsson , Á , Gislason , G K , Olafsson , A , Steingrímsdóttir , H , Kampanis , P , Hultcrantz , M , Durie , B G M , Harding , S , Landgren , O , Palsson , R , Love , T J & Kristinsson , S Y 2021 , ' Monoclonal gammopathy of undetermined significance and COVID-19 : a population-based cohort study ' , Blood Cancer Journal , vol. 11 , no. 12 , 191 , pp. 191 . https://doi.org/10.1038/s41408-021-00580-7


Multiple myeloma (MM) patients have increased risk of severe coronavirus disease 2019 (COVID-19) when infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Monoclonal gammopathy of undetermined significance (MGUS), the precursor of MM has been associated with immune dysfunction which may lead to severe COVID-19. No systematic data have been published on COVID-19 in individuals with MGUS. We conducted a large population-based cohort study evaluating the risk of SARS-CoV-2 infection and severe COVID-19 among individuals with MGUS. We included 75,422 Icelanders born before 1976, who had been screened for MGUS in the Iceland Screens Treats or Prevents Multiple Myeloma study (iStopMM). Data on SARS-CoV-2 testing and COVID-19 severity were acquired from the Icelandic COVID-19 Study Group. Using a test-negative study design, we included 32,047 iStopMM participants who had been tested for SARS-CoV-2, of whom 1754 had MGUS. Among these participants, 1100 participants, tested positive, 65 of whom had MGUS. Severe COVID-19 developed in 230 participants, including 16 with MGUS. MGUS was not associated with SARS-CoV-2 infection (Odds ratio (OR): 1.05; 95% confidence interval (CI): 0.81–1.36; p = 0.72) or severe COVID-19 (OR: 0.99; 95%CI: 0.52–1.91; p = 0.99). These findings indicate that MGUS does not affect the susceptibility to SARS-CoV-2 or the severity of COVID-19.


The iStopMM study is funded by the Black Swan Research Initiative by the International Myeloma Foundation, the European Research Council, and the Icelandic Center for Research. Screening tests were performed by The Binding Site Ltd, Birmingham, UK. Additional funding for the iStopMM study is provided by the University of Iceland, Landspítali—The National University Hospital of Iceland, and the Icelandic Cancer Society. The iStopMM study is made possible the nurses, data scientists, and other staff of the study as well as by the hundreds of nurses and laboratory technicians who had collected blood samples for the study. Most importantly, our gratitude goes to the thousands of Icelanders who have generously provided their informed consent for the study, answered questionnaires, provided blood samples, and undergone diagnostic testing and follow-up. Publisher Copyright: © 2021, The Author(s).

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