Does androgen deprivation therapy protect against severe complications from COVID-19?
Retrospective 58 prostate cancer patients in the USA, showing lower risk of hospitalization with ADT.
risk of death, 55.2% lower, RR 0.45, p = 0.22, treatment 4 of 22 (18.2%), control 10 of 36 (27.8%), adjusted per study, odds ratio converted to relative risk, multivariable.
risk of mechanical ventilation, 69.0% lower, OR 0.31, p = 0.19, treatment 22, control 36, adjusted per study, multivariable, RR approximated with OR.
risk of hospitalization, 77.0% lower, OR 0.23, p = 0.02, treatment 22, control 36, adjusted per study, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Patel et al., 9 Jul 2020, retrospective, USA, peer-reviewed, 7 authors, study period 1 March, 2020 - 4 June, 2020.
Abstract: Annals of Oncology
Letters to the Editor
investigation, including antiviral drugs, we suggest that
convalescent plasma could be useful in patients with COVID19 infection and concurrent persistent B-cell immunodeﬁciency; we will consider this approach for our patient.3e5
N. Issa1*, F. Lacassin2 & F. Camou1
Medical Intensive Care and Infectious Diseases Unit, SaintAndre Hospital, CHU Bordeaux, Bordeaux;
Infectious Disease Department, Mont de Marsan Hospital,
Mont de Marsan, France
Available online 29 June 2020
© 2020 European Society for Medical Oncology. Published
by Elsevier Ltd. All rights reserved.
The authors have declared no conﬂicts of interest.
1. Berlin DA, Gulick RM, Martinez FJ. Severe Covid-19. N Engl J Med. 2020.
2. Gao Y, Chen Y, Liu M, Shi S, Tian J. Impacts of immunosuppression and
immunodeﬁciency on COVID-19: a systematic review and meta-analysis.
J Infect. 2020;81(2):e93ee95.
3. Valk SJ, Piechotta V, Chai KL, et al. Convalescent plasma or hyperimmune
immunoglobulin for people with COVID-19: a rapid review. Cochrane
Database Syst Rev. 2020;5:CD013600.
4. Franchini M. Why should we use convalescent plasma for COVID-19? Eur
J Intern Med. 2020;77:150e151.
5. Pinto D, Park YJ, Beltramello M, et al. Cross-neutralization of SARS-CoV-2
by a human monoclonal SARS-CoV antibody. Nature. 2020;583(7815):
Does androgen deprivation therapy protect
against severe complications from COVID-19?
Currently, there is a paucity of effective treatments to
address the remarkably high morbidity and mortality
associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) coronavirus disease-19 (COVID-19).
This letter highlights a potential therapeutic strategy based
on known biology of SARS-CoV-2 cellular entry and
SARS-CoV-2 relies on surface expression of angiotensinconverting enzyme 2 (ACE2) and transmembrane serine
proteases 2 (TMPRSS2) for cellular entry and replication in
the respiratory epithelium.1,2 In in vitro and mouse models,
Volume 31 - Issue 10 - 2020
TMPRSS2 inhibition limits respiratory cell damage and
reduces severity of infection.1,3 TMPRSS2 is commonly
expressed in prostate cancer cells and is known to be
regulated by androgens.4 Hence, androgen deprivation
therapy (ADT) may theoretically reduce TMPRSS2 expression limiting SARS-CoV-2 cellular entry and preventing
severe complications from COVID-19. In fact, a recent
report from Alimonti and colleagues demonstrated a lower
rate of infection in prostate cancer patients on ADT,
compared with those not on ADT.5 Herein, we report our
observational study of all patients in a single New York City
health system with COVID-19 and prostate cancer to
determine the impact of ADT on COVID-19 clinical outcomes. To our best knowledge, this is the largest study to
report severity of COVID-19 in patients receiving ADT.
This study was approved by the Mount Sinai School of
Medicine Institutional Review Board. We identiﬁed all
Mount Sinai Health System (MSHS) patients with prostate
cancer and SARS-CoV-2 viral detection by PCR (based on
testing within and outside MSHS) from 1 March 2020 to
4 June 2020. We collected clinical information including
demographics, medical history, and medications including
ADT use. ADT use was deﬁned as a gonadotropin-releasing
hormone (GnRH) analog or..
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, 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. FLCCC
provide treatment protocols.