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The clinical impact of androgen deprivation therapy on SARS-CoV-2 infection rates and disease severity

Kazan et al., Türk Üroloji Dergisi/Turkish Journal of Urology, doi:10.5152/tud.2021.21278
Nov 2021  
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Hospitalization -229% Improvement Relative Risk Case 29% Antiandrogens for COVID-19  Kazan et al.  Prophylaxis Is prophylaxis with antiandrogens beneficial for COVID-19? Retrospective 365 patients in Turkey (August 2020 - June 2021) Higher hospitalization (p=0.2) and fewer cases (p=0.32), not sig. c19early.org Kazan et al., Türk Üroloji Dergisi/Tur.., Nov 2021 Favorsvarious Favorscontrol 0 0.5 1 1.5 2+
7th treatment shown to reduce risk in September 2020, now with p = 0.000000056 from 49 studies.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 112 treatments. c19early.org
Retrospective 365 prostate cancer patients in Turkey, 138 treated with ADT, showing no significant differences with treatment.
This study is excluded in the after exclusion results of meta analysis: excessive unadjusted differences between groups.
risk of hospitalization, 229.0% higher, RR 3.29, p = 0.20, treatment 4 of 138 (2.9%), control 2 of 227 (0.9%).
risk of case, 28.7% lower, RR 0.71, p = 0.32, treatment 13 of 138 (9.4%), control 30 of 227 (13.2%), NNT 26.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Kazan et al., 1 Nov 2021, retrospective, Turkey, peer-reviewed, 10 authors, study period August 2020 - June 2021.
This PaperAntiandrogensAll
The clinical impact of androgen deprivation therapy on SARS-CoV-2 infection rates and disease severity
Özgür Kazan, Meftun Çulpan, Özgür Efiloğlu, Gökhan Atis, Asıf Yildirim
Türk Üroloji Dergisi/Turkish Journal of Urology, doi:10.5152/tud.2021.21278
Objective: The protective effect of androgen deprivation therapy (ADT) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel hypothesis. ADT may protect patients with prostate cancer through the inhibition of androgen receptor-dependent transmembrane serine protease type 2. We analyzed the role of ADT on SARS-CoV-2 infection risk and disease severity. Material and methods: Between August 2020 and June 2021, patients with prostate cancer were included in our study. Patients were divided into two groups as men receiving ADT or not. Patients' characteristics such as prostate cancer grade and stage, comorbidities, SARS-CoV-2 infection status, and infection severity were assessed. SARS-CoV-2-infected close relatives and patients' compliance with the precautions against SARS-CoV-2 were also analyzed. Results: A total of 365 patients, 138 (37.8%) with ADT and 227 (62.2%) without ADT, were included in our analysis. Patients with ADT were older (71.8 vs 66.9 years, P ¼ .001) and had a higher rate of chronic obstructive pulmonary disease (11.6% vs 5.7%, P ¼ .044). Patients receiving ADT were more often locally advanced and metastatic (80.4% vs 32.6%, P ¼ .001). SARS-CoV-2 infection rates were statistically similar between patients who received and did not receive ADT (9.4% vs 13.2%, P ¼ .275, respectively). There was no significant difference between two groups in terms of hospitalization rates (2.9% vs 0.9%, P ¼ .205). In multivariate analysis, the presence of SARS-CoV-2-infected close relatives and precautions score were only independent predictors for both risk of SARS-CoV-2 infection and infection severity. Conclusion: We could not find any effect of ADT on risk and severity of SARS-CoV-2 infection. SARS-CoV-2 infection and hospitalization rates were similar between patients with and without ADT.
Ethics Committee Approval: Ethical committee approval was received from the _ Istanbul Medeniyet University (2021/440). Informed Consent: Written informed consent was obtained from all participants who participated in this study. Peer-review: Externally peer-reviewed. Author
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