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Impact of anti-androgen therapies on COVID-19 susceptibility: a case-control study in male population from two COVID-19 regional centers of Lombardy (Italy)

Lazzeri et al., medRxiv, doi:10.1101/2020.04.20.20068056
Sep 2020  
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Retrospective case-control study in Italy with 943 male COVID-19 patients, 45 on chronic 5ARI treatment (finasteride/dutasteride). There was significantly fewer COVID-19 patients >55 on 5ARI treatment compared to age-matched controls (5.57 vs. 8.14%, p=0.0083). The difference was greater for men aged >65 (7.14 vs. 12.31%, p=0.0001). There was no significant difference for ICU admission or death.
risk of death/ICU, 23.0% higher, OR 1.23, p = 0.33, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Lazzeri et al., 21 Sep 2020, retrospective, Italy, preprint, 11 authors.
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Impact of anti-androgen therapies on COVID-19 susceptibility: a case-control study in male population from two COVID-19 regional centers of Lombardy (Italy)
MD-PhD Massimo Lazzeri, PhD Stefano Duga, MD Elena Azzolini, MD Vittorio Fasulo, MD Nicolò Buffi, MD Alberto Saita, MD Rodolfo Hurle, MD Alessandro Nobili, MD-PhD Maurizio Cecconi, MD Paolo Casale, PhD Rosanna Asselta
May treatment of benign prostatic hyperplasia with 5-alpha reductase inhibitors (5ARIs) impact on COVID-19-related hospitalization risk? Findings: In this case-control study, which compared 943 adult males hospitalized for COVID-19 with age-matched men from Lombardy (all beneficiaries of the Regional Health Service), the proportion of patients aged >55 years, who were exposed to 5ARIs (dutasteride, finasteride), was significantly lower (5.57%) than that of the general male population (8.14%) (p=0.0083, 95%CI=0.75-3.97%). Meaning: The use of 5ARIs was associated with a potential reduced risk of hospitalization for COVID-19 in men older than >55 years. This suggests the opportunity to test whether antiandrogen therapies can prevent the transition from paucisymptomatic SARS-CoV-2 infection to overt pulmonary disease.
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