Impact of androgen deprivation therapy on mortality of prostate cancer patients with COVID-19: a propensity score-based analysis

DOI record: { "DOI": "10.1186/s13027-021-00406-y", "ISSN": [ "1750-9378" ], "URL": "http://dx.doi.org/10.1186/s13027-021-00406-y", "abstract": "<jats:title>Abstract</jats:title><jats:sec>\n <jats:title>Background</jats:title>\n <jats:p>Previous studies hypothesized that androgen deprivation therapy (ADT) may reduce severe acute respiratory syndrome coronavirus 2 (SARS-COV2) infectivity. However, it is unknown whether there is an association between ADT and a higher survival in prostate cancer patients with COVID-19.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Methods</jats:title>\n <jats:p>We performed a retrospective analysis of prostate cancer (PC) patients hospitalized to treat COVID-19 in Brazil’s public health system. We compared patients with the active use of ADT versus those with non-active ADT, past use. We constructed propensity score models of patients in active versus non-active use of ADT. All variables were used to derive propensity score estimation in both models. In the first model we performed a pair-matched propensity score model between those under active and non-active use of ADT. To the second model we initially performed a multivariate backward elimination process to select variables to a final inverse-weight adjusted with double robust estimation model.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Results</jats:title>\n <jats:p>We analyzed 199 PC patients with COVID-19 that received ADT. In total, 52.3% (95/199) of our patients were less than 75 years old, 78.4% (156/199) were on active ADT, and most were using a GnRH analog (80.1%; 125/156). Most of patients were in palliative treatment (89.9%; 179/199). Also, 63.3% of our cohort died from COVID-19. Forty-eight patients under active ADT were pair matched against 48 controls (non-active ADT). All patients (199) were analyzed in the double robust model. ADT active use were not protective factor in both inverse-weight based propensity score (OR 0.70, 95% CI 0.38–1.31, <jats:italic>P</jats:italic> = 0.263), and pair-matched propensity score (OR 0.67, 95% CI 0.27–1.63, <jats:italic>P</jats:italic> = 0.374) models. We noticed a significant imbalance in the propensity score of patients in active and those in non-active ADT, with important reductions in the differences after the adjustments.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Conclusions</jats:title>\n <jats:p>The active use of ADT was not associated with a reduced risk of death in patients with COVID-19.</jats:p>\n </jats:sec>", "alternative-id": [ "406" ], "article-number": "66", "assertion": [ { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Received", "name": "received", "order": 1, "value": "9 July 2021" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Accepted", "name": "accepted", "order": 2, "value": "11 November 2021" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "First Online", "name": "first_online", "order": 3, "value": "25 November 2021" }, { "group": { "label": "Declarations", "name": "EthicsHeading" }, "name": "Ethics", "order": 1 }, { "group": { "label": "Ethics approval and consent to participate", "name": "EthicsHeading" }, "name": "Ethics", "order": 2, "value": "The project was submitted and approved by our institutional ethics (Comitê de Ética em Pesquisa (CEP) da Universidade Estadual de Campinas) commitment and the consent form was waived." }, { "group": { "label": "Consent for publication", "name": "EthicsHeading" }, "name": "Ethics", "order": 3, "value": "The project was submitted and approved by our institutional ethics (Comitê de Ética em Pesquisa (CEP) da Universidade Estadual de Campinas) commitment and the consent form was waived." }, { "group": { "label": "Competing interests", "name": "EthicsHeading" }, "name": "Ethics", "order": 4, "value": "The authors declare that they have no competing interests." } ], "author": [ { "affiliation": [], "family": "Duarte", "given": "Mateus Bringel Oliveira", "sequence": "first" }, { "affiliation": [], "family": "Leal", "given": "Frederico", "sequence": "additional" }, { "affiliation": [], "family": "Argenton", "given": "Juliana Luz Passos", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0002-0136-0943", "affiliation": [], "authenticated-orcid": false, "family": "Carvalheira", "given": "José Barreto Campello", "sequence": "additional" } ], "container-title": [ "Infectious Agents and Cancer" ], "content-domain": { "crossmark-restriction": false, "domain": [ "link.springer.com" ] }, "created": { "date-parts": [ [ 2021, 11, 30 ] ], "date-time": "2021-11-30T18:32:03Z", "timestamp": 1638297123000 }, "deposited": { "date-parts": [ [ 2021, 11, 30 ] ], "date-time": "2021-11-30T18:40:32Z", "timestamp": 1638297632000 }, "funder": [ { "DOI": "10.13039/501100001807", "award": [ "2018/23428‐0" ], "doi-asserted-by": "publisher", "name": "fundação de amparo à pesquisa do estado de são paulo" } ], "indexed": { "date-parts": [ [ 2021, 12, 10 ] ], "date-time": "2021-12-10T03:28:51Z", "timestamp": 1639106931736 }, "is-referenced-by-count": 0, "issn-type": [ { "type": "electronic", "value": "1750-9378" } ], "issue": "1", "issued": { "date-parts": [ [ 2021, 11, 25 ] ] }, "journal-issue": { "issue": "1", "published-print": { "date-parts": [ [ 2021, 12 ] ] } }, "language": "en", "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0", "content-version": "tdm", "delay-in-days": 0, "start": { "date-parts": [ [ 2021, 11, 25 ] ], "date-time": "2021-11-25T00:00:00Z", "timestamp": 1637798400000 } }, { "URL": "https://creativecommons.org/licenses/by/4.0", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2021, 11, 25 ] ], "date-time": "2021-11-25T00:00:00Z", "timestamp": 1637798400000 } } ], "link": [ { "URL": "https://link.springer.com/content/pdf/10.1186/s13027-021-00406-y.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://link.springer.com/article/10.1186/s13027-021-00406-y/fulltext.html", "content-type": "text/html", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://link.springer.com/content/pdf/10.1186/s13027-021-00406-y.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "297", "original-title": [], "prefix": "10.1186", "published": { "date-parts": [ [ 2021, 11, 25 ] ] }, "published-online": { "date-parts": [ [ 2021, 11, 25 ] ] }, "published-print": { "date-parts": [ [ 2021, 12 ] ] }, "publisher": "Springer Science and Business Media LLC", "reference": [ { "author": "SH Woolf", "first-page": "123", "journal-title": "JAMA", "key": "406_CR1", "unstructured": "Woolf SH, Chapman DA, Lee JH. 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