Androgen deprivation therapy, comorbidity, cancer stage and mortality from COVID-19 in men with prostate cancer
Gedeborg et al.
, Androgen deprivation therapy, comorbidity, cancer stage and mortality from COVID-19 in men with prostate..
, Scandinavian Journal of Urology, doi:10.1080/21681805.2021.2019304
Case control study with 474 patients that died of COVID-19 in Sweden, showing higher risk with ADT, without statistical significance.
risk of death, 25.0% higher, OR 1.25, p = 0.11, treatment 271 of 474 (57.2%) cases,
5,181 of 23,700 (21.9%) controls, case control OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Gedeborg et al., 23 Dec 2021, retrospective, Sweden, peer-reviewed, 6 authors.
Abstract: Scandinavian Journal of Urology
ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/isju20
Androgen deprivation therapy, comorbidity,
cancer stage and mortality from COVID-19 in men
with prostate cancer
Rolf Gedeborg, Lars Lindhagen, Stacy Loeb, Johan Styrke, Hans Garmo & Pär
To cite this article: Rolf Gedeborg, Lars Lindhagen, Stacy Loeb, Johan Styrke, Hans
Garmo & Pär Stattin (2021): Androgen deprivation therapy, comorbidity, cancer stage and
mortality from COVID-19 in men with prostate cancer, Scandinavian Journal of Urology, DOI:
To link to this article: https://doi.org/10.1080/21681805.2021.2019304
© 2021 The Author(s). Published by Informa
UK Limited, trading as Taylor & Francis
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Published online: 23 Dec 2021.
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SCANDINAVIAN JOURNAL OF UROLOGY
Androgen deprivation therapy, comorbidity, cancer stage and mortality from
COVID-19 in men with prostate cancer
, Lars Lindhagenb, Stacy Loebc, Johan Styrked, Hans Garmoa,e and P€ar Stattina
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; bUppsala Clinical Research Center (UCR), Uppsala, Sweden;
Department of Urology and Population Health, New York University and Manhattan Veterans Affairs Medical Center, New York, NY, USA;
Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden; eTranslational Oncology and
Urology Research (TOUR), King’s College London, Guy’s Hospital, London, UK
Background: Androgens facilitate entrance of the severe acute respiratory syndrome coronavirus 2
into respiratory epithelial cells, and male sex is associated with a higher risk of death from corona
virus disease (COVID-19). Androgen deprivation therapy (ADT) could possibly improve COVID19 outcomes.
Methods: In a case–control study nested in the Prostate Cancer data Base Sweden (PCBaSe) RAPID
2019, we evaluated the association between ADT and COVID-19 as registered cause of death in men
with prostate cancer. Each case was matched to 50 controls by region. We used conditional logistic
regression to adjust for confounders and also evaluated potential impact of residual confounding.
Results: We identified 474 men who died from COVID-19 in March–December 2020. In crude analyses,
ADT exposure was associated with an increased risk of COVID-19 death (odds ratio [OR] 5.05, 95% CI:
4.18–6.10); however, the OR was substantially attenuated after adjustment for age, comorbidity, prostate cancer characteristics at diagnosis, recent healthcare use, and indicators of advanced cancer
(adjusted OR 1.25, 95% CI: 0.95–1.65). If adjustment has accounted for at least 85% of confounding,
then the true effect could be no more than a 5% reduction of the odds for COVID-19 death.
Conclusions: The increased mortality from COVID-19 in men with prostate cancer treated with ADT
was mainly related to high age, comorbidity, and more advanced prostate cancer. There was no evidence to support the hypothesis that ADT is associated with improved COVID-19 outcomes.
Received 5 October 2021
Accepted 30 November..
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