Influence of androgen deprivation therapy on the severity of COVID-19 in prostate cancer patients
Jiménez-Alcaide et al.,
Influence of androgen deprivation therapy on the severity of COVID-19 in prostate cancer patients,
The Prostate, doi:10.1002/pros.24232
Retrospective 1,349 prostate cancer patients in Spain, 156 on ADT, showing no significant differences in COVID-19 outcomes with treatment.
Although the 33% lower mortality is not statistically significant, it is consistent with the significant 38% lower mortality
[21‑51%] from meta analysis of the
32 mortality results to date.
risk of death, 33.0% lower, RR 0.67, p = 0.41, treatment 3 of 11 (27.3%), control 17 of 50 (34.0%), adjusted per study, multivariable.
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risk of progression, 8.0% higher, RR 1.08, p = 0.77, treatment 11, control 50, adjusted per study, multivariable.
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risk of case, 68.2% higher, RR 1.68, p = 0.15, treatment 11 of 156 (7.1%), control 50 of 1,193 (4.2%), excluded in exclusion analyses:
excessive unadjusted differences between groups.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Jiménez-Alcaide et al., 13 Sep 2021, retrospective, Spain, peer-reviewed, 9 authors.
Abstract: Received: 25 March 2021
| Accepted: 30 August 2021
DOI: 10.1002/pros.24232
ORIGINAL ARTICLE
Influence of androgen deprivation therapy on the severity of
COVID‐19 in prostate cancer patients
Estíbaliz Jiménez‐Alcaide MD1
| Clara García‐Fuentes MD1 |
Virginia Hernández MD, PhD1 | Enrique De la Peña MD, PhD1 |
Elia Pérez‐Fernández MSc2 | Alejandro Castro MD1 | Begoña Caballero‐Perea MD3 |
Ana Guijarro MD1
|
Carlos Llorente MD, PhD1
1
Department of Urology, Hospital
Universitario Fundación Alcorcón, Madrid,
Spain
Abstract
Background: The TMPRSS2 protein has been involved in severe acute respiratory
2
Research Unit, Hospital Universitario
Fundación Alcorcón, Madrid, Spain
3
Department of Radiation Oncology, Hospital
Universitario de Fuenlabrada, Madrid, Spain
Correspondence
Estíbaliz Jiménez‐Alcaide, MD, Department of
Urology, Hospital Universitario Fundación
Alcorcón, Avda. Budapest 1, 28922 Alcorcón,
Madrid, Spain.
Email: estibaliz.jimenez@salud.madrid.org and
estibalizjimenez85@gmail.com
syndrome caused by coronavirus 2 (SARS‐CoV‐2). The production is regulated by
the androgen receptor (AR). It is speculated that androgen deprivation therapy (ADT)
may protect patients affected by prostate cancer (PC) from SARS‐CoV‐2 infection.
Methods: This is a retrospective study of patients treated for COVID‐19 in our
institution who had a previous diagnosis of PC. We analyzed the influence of exposure of ADT on the presence of severe course of COVID‐19.
Results: A total of 2280 patients were treated in our center for COVID‐19 with a
worse course of disease in males (higher rates of hospitalization, intense care unit
[ICU] admission, and death). Out of 1349 subjects registered in our PC database, 156
were on ADT and 1193 were not. Out of those, 61 (4.52%) PC patients suffered
from COVID‐19, 11 (18.0%) belonged to the ADT group, and 50 (82.0%) to the non‐
ADT group. Regarding the influence of ADT on the course of the disease, statistically
significant differences were found neither in the death rate (27.3% vs. 34%;
p = 0.481), nor in the presence of severe COVID‐19: need for intubation or ICU
admission (0% vs. 6.3%; p = 0.561) and need for corticoid treatment, interferon beta,
or tocilizumab (60% vs. 34.7%; p = 0.128). Multivariate analysis adjusted for clinically
relevant comorbidities did not find that ADT was a protective factor for worse
clinical evolution (risk ratio [RR] 1.08; 95% confidence interval [CI], 0.64–1.83;
p = 0.77) or death (RR, 0.67; 95% CI, 0.26–1.74; p = 0.41).
Conclusions: Our study confirms that COVID‐19 is more severe in men. However,
the use of ADT in patients with PC was not shown to prevent the risk of severe
COVID‐19.
KEYWORDS
androgen deprivation therapy, COVID‐19, prostatic neoplasms, SARS‐CoV‐2
The Prostate. 2021;81:1349–1354.
wileyonlinelibrary.com/journal/pros
© 2021 Wiley Periodicals LLC
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1350
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JIMÉNEZ‐ALCAIDE ET AL.
| INTRODUCTION
First of all, demographic characteristics of both groups of patients
were analyzed including age and comorbidity measured according to the
In late 2019, a new human coronavirus (SARS‐CoV‐2) causing severe
Charlson Index, as well as data related to PC: prostate‐specific antigen
acute respiratory syndrome (SARS)1–3 was isolated for the first time in
(PSA), tumor‐node‐metastases (TNM) stage, Gleason grading system, and
Wuhan, China. SARS‐CoV‐2 causes a broad spectrum of diseases that are
the primary treatment regime received at diagnosis (radical..
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