Background People experiencing homelessness are at increased risk of COVID-19, but little is known about specific risk factors for infection within homeless shelters. Methods We performed widespread SARS-CoV-2 PCR testing and collected risk factor information at all homeless shelters in Chicago with at least one reported case of COVID-19 (n=21). Multivariable, mixed-effects log-binomial models were built to estimate adjusted prevalence ratios (aPRs) for SARS-CoV-2 infection for both individual and facility-level risk factors. Results During March 1 to May 1, 2020, 1717 shelter residents and staff were tested for SARS-CoV-2; 472 (27%) persons tested positive. Prevalence of infection was higher for residents (431/1435, 30%) than for staff (41/282, 15%) (prevalence ratio [PR] =2.52, 95% CI 1.78–3.58). The majority of residents with SARS-CoV-2 infection (293/406 with available information about symptoms, 72%) reported no symptoms at the time of specimen collection or within the following two weeks.Among residents, sharing a room with a large number of people was associated with increased likelihood of infection (aPR for sharing with >20 people compared to single rooms = 1.76, 95% CI 1.11–2.80), and current smoking was associated with reduced likelihood of infection (aPR=0.71, 95% CI 0.60–0.85). At the facility-level, a higher proportion of residents leaving and returning each day was associated with increased prevalence (aPR=1.08, 95% CI 1.01–1.16), while an increase in the number of private bathrooms was associated with reduced prevalence (aPR for one additional private bathroom per 100 people = 0.92, 95% CI 0.87–0.98). Conclusions We identified a high prevalence of SARS-CoV-2 infections in homeless shelters. Reducing the number of residents sharing dormitories might reduce the likelihood of SARS-CoV-2 infection. When community transmission is high, limiting movement of persons experiencing homelessness into and out of shelters might also be beneficial.

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e19069 Background: The prognostic factors influencing survival and optimal management of primary pulmonary lymphomas (PPLs) have not been clearly defined due to rarity of the disease. This study sought to characterize the significant prognostic factors of PPL and develop a prognostic nomogram for individualized prediction of survival outcomes in patients with PPL. Methods: Patients diagnosed with PPL between 1983 and 2010 were identified using the Surveillance, Epidemiology, and End Results (SEER) Program database. Kaplan-Meier survival analysis and Cox proportional hazards regression model were performed to identify significant independent prognostic factors for overall survival (OS) in patients with PPL. A nomogram was constructed for the prediction of 5-year OS probability based on these variables. Results: The study cohort of 2325 PPL patients has a 5-year OS rate of 52% and a median OS of 67 months. Older age at diagnosis (HR 1.031; 95% CI, 1.026-1.036; p<0.001], males (HR 1.434; 95% CI, 1.267-1.622; p<0.001), Hispanic race (HR 1.370; 95% CI, 1.113-1.687; p=0.003), non-marginal zone B-cell lymphoma of mucosa associated lymphoid tissue (MALT) histology (p<0.001), primary site at main bronchus (HR 1.326; 95% CI, 1.014-1.735; p=0.039), Ann Arbor stage IV (HR 1.542; 95% CI, 1.324-1.795; p<0.001) were significantly associated with worse OS. All treatment modalities, including chemotherapy (HR 0.615; 95% CI, 0.536-0.706; p<0.001), surgery (HR 0.666;95% CI, 0.577-0.769; p<0.001) and radiotherapy (HR 0.829; 95% CI, 0.693-0.992; p=0.041) were independent predictors of survival. The nomogram constructed using these variables has a higher concordance index of 0.716 (95% CI, 0.699-0.734) compared to that of Ann Arbor staging system [0.571 (95% CI,0.552-0.591); p<0.001]. Conclusions: Older age, male sex, Hispanic race, non-MALT histology, primary site at main bronchus, advanced Ann Arbor stage, not receiving treatment were independent prognostic factors that are associated with worse OS in patients with PPL. The nomogram demonstrated good agreement between the predicted probabilities and actual observations on calibration plots.

IntroductionMultiple myeloma (MM) is a neoplastic proliferation of bone marrow plasma cells that manufacture the monoclonal immunoglobulin. Kidney disease has been a principal cause of morbidity in patients with MM, and approximately, 40%–50% present with kidney function impairment at diagnosis. Many factors may manipulate the kidney function, for instance, cast nephropathy, hypercalcaemia, hyperuricaemia, infection, hyperviscosity and chemotherapeutic agents can precipitate renal damage. Herein, we aim to investigate and analyse the paramount risk factors associated with mortality due to renal diseases in MM.Material and methodsWe used the Surveillance, Epidemiology, and End Results (SEER) program for 1973–2010 and evaluated 55 991 patients with MM. Univariate and multivariate hazard regression model were used to identify potential risk factors for mortality from kidney diseases. In addition, survival curves were drawn out using the Kaplan–Meier method. The log–rank test was used to compare the survival distributions.Results and discussionsThe mortality due to kidney diseases was the third most common cause of death (5.47%) after thromboembolic events and multiple myeloma. However, the kidney diseases specific survival improved over time. Multiple myeloma specific survival rate was 42.7% while the overall survival rate at the study end points was 25.6%. Multivariate Cox Regression analysis demonstrated that increased risk of mortality due to renal diseases was associated with age ≥60 years, not-married, white race, and radiation therapy (all, p<0.001). No significant differences in survival between male and female.ConclusionThe mortality from renal affection in MM patients was associated with being elder, not-married, white race, and radiation therapy. Our considerations and further investigations of these risk factors is needful. It may promote our comprehension to MM and lessen the kidney deterioration with our prospects for improving in the overall survival.