Androgen Deprivation Therapy in Men with Prostate Cancer Does Not Affect Risk of Infection with SARS-CoV-2

Klein et al., Journal of Urology, doi:10.1097/JU.0000000000001338, Feb 2021
Mortality -124% improvement lower risk ← → higher risk Case 7% Antiandrogens  Klein et al.  PROPHYLAXIS Is prophylaxis with antiandrogens beneficial for COVID-19? Retrospective 1,779 patients in the USA (March - June 2020) Higher mortality with antiandrogens (not stat. sig., p=0.12) c19early.org Klein et al., J. Urology, February 2021 0 0.5 1 1.5 2+ RR
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.
6,200+ studies for 200+ treatments. c19early.org
Retrospective 1,779 prostate cancer patients, showing no significant differences in COVID-19 outcomes with ADT.
Standard of Care (SOC) for COVID-19 in the study country, the USA, is very poor with very low average efficacy for approved treatments1. Only expensive, high-profit treatments were approved for early treatment. Low-cost treatments were excluded, reducing the probability of early treatment due to access and cost barriers, and eliminating complementary and synergistic benefits seen with many low-cost treatments.
risk of death, 123.9% higher, RR 2.24, p = 0.12, treatment 6 of 304 (2.0%), control 13 of 1,475 (0.9%).
risk of case, 6.6% lower, RR 0.93, p = 0.80, treatment 17 of 304 (5.6%), control 85 of 1,475 (5.8%), NNT 586, adjusted per study, odds ratio converted to relative risk, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Klein et al., 1 Feb 2021, retrospective, USA, peer-reviewed, 7 authors, study period 12 March, 2020 - 10 June, 2020.
$0 $500 $1,000+ Efficacy vs. cost for COVID-19 treatment protocols c19early.org November 2025 USA Russia Sudan Angola Colombia Kenya Mozambique Vietnam Peru Philippines Spain Brazil Italy France Japan Canada China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Bosnia-Herzegovina Ukraine Côte d'Ivoire Bulgaria Greece Slovakia Singapore Iceland New Zealand Czechia Mongolia Israel Trinidad and Tobago Hong Kong North Macedonia Belarus Qatar Panama Serbia CAR USA favored high-profit treatments.The average efficacy of treatments was very low.High-cost protocols reduce early treatment, andforgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
$0 $500 $1,000+ Efficacy vs. cost for COVID-19treatment protocols worldwide c19early.org November 2025 USA Russia Sudan Angola Colombia Kenya Mozambique Vietnam Peru Philippines Spain Brazil Italy France Japan Canada China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Ukraine Côte d'Ivoire Eritrea Bulgaria Greece Slovakia Singapore New Zealand Malawi Czechia Mongolia Israel Trinidad and Tobago North Macedonia Belarus Qatar Panama Serbia Syria USA favored high-profit treatments.The average efficacy was very low.High-cost protocols reduce early treatment,and forgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
DOI record: { "DOI": "10.1097/ju.0000000000001338", "ISSN": [ "0022-5347", "1527-3792" ], "URL": "http://dx.doi.org/10.1097/ju.0000000000001338", "alternative-id": [ "10.1097/JU.0000000000001338" ], "author": [ { "affiliation": [ { "name": "Department of Urology, Glickman Urological and Kidney Institute, Cleveland, Ohio" } ], "family": "Klein", "given": "Eric A.", "sequence": "first" }, { "affiliation": [ { "name": "Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland, Ohio" } ], "family": "Li", "given": "Jianbo", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland, Ohio" } ], "family": "Milinovich", "given": "Alex", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland, Ohio" } ], "family": "Schold", "given": "Jesse D.", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Cancer Biology and Genitourinary Malignancies Research Center,Lerner Research Institute, Cleveland, Ohio" } ], "family": "Sharifi", "given": "Nima", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland, Ohio" } ], "family": "Kattan", "given": "Michael W.", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Neurology, Neurological Institute Cleveland Clinic and Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio" } ], "family": "Jehi", "given": "Lara", "sequence": "additional" } ], "container-title": [ "Journal of Urology" ], "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2020, 9, 8 ] ], "date-time": "2020-09-08T20:09:40Z", "timestamp": 1599595780000 }, "deposited": { "date-parts": [ [ 2022, 3, 25 ] ], "date-time": "2022-03-25T00:27:05Z", "timestamp": 1648168025000 }, "indexed": { "date-parts": [ [ 2022, 3, 25 ] ], "date-time": "2022-03-25T19:28:38Z", "timestamp": 1648236518979 }, "is-referenced-by-count": 19, "issn-type": [ { "type": "print", "value": "0022-5347" }, { "type": "electronic", "value": "1527-3792" } ], "issue": "2", "issued": { "date-parts": [ [ 2021, 2 ] ] }, "journal-issue": { "issue": "2", "published-print": { "date-parts": [ [ 2021, 2 ] ] } }, "language": "en", "member": "276", "original-title": [], "page": "441-443", "prefix": "10.1097", "published": { "date-parts": [ [ 2021, 2 ] ] }, "published-print": { "date-parts": [ [ 2021, 2 ] ] }, "publisher": "Ovid Technologies (Wolters Kluwer Health)", "reference-count": 0, "references-count": 0, "relation": {}, "resource": { "primary": { "URL": "http://www.jurology.com/doi/10.1097/JU.0000000000001338" } }, "score": 1, "short-container-title": [ "Journal of Urology" ], "short-title": [], "source": "Crossref", "subject": [ "Urology" ], "subtitle": [], "title": [ "Androgen Deprivation Therapy in Men with Prostate Cancer Does Not Affect Risk of Infection with SARS-CoV-2" ], "type": "journal-article", "volume": "205" }
Please send us corrections, updates, or comments. c19early involves the extraction of 200,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. IMA and WCH provide treatment protocols.
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