Association Between Androgen Deprivation Therapy and Mortality Among Patients With Prostate Cancer and COVID-19
Retrospective 1,106 prostate cancer patients, showing no significant differences in COVID-19 outcomes with ADT.
risk of death, 20.4% lower, RR 0.80, p = 0.41, treatment 25 of 169 (14.8%), control 44 of 308 (14.3%), adjusted per study, odds ratio converted to relative risk, propensity score matching, multivariable.
risk of severe case, 2.0% lower, OR 0.98, p = 0.94, treatment 169, control 308, adjusted per study, propensity score matching, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Schmidt et al., 12 Nov 2021, retrospective, USA, peer-reviewed, 42 authors, study period 17 March, 2020 - 11 February, 2021.
Abstract: Original Investigation | Urology
Association Between Androgen Deprivation Therapy and Mortality
Among Patients With Prostate Cancer and COVID-19
Andrew L. Schmidt, MD; Matthew D. Tucker, MD; Ziad Bakouny, MD; Chris Labaki, MD; Chih-Yuan Hsu, PhD; Yu Shyr, PhD; Andrew J. Armstrong, MD; Tomasz M. Beer, MD;
Ragneel R. Bijjula, MD; Mehmet A. Bilen, MD; Cindy F. Connell, MD, PhD; Scott Joseph Dawsey, MD; Bryan Faller, MD; Xin Gao, MD; Benjamin A. Gartrell, MD;
David Gill, MD; Shuchi Gulati, MD; Susan Halabi, PhD; Clara Hwang, MD; Monika Joshi, MD; Ali Raza Khaki, MD; Harry Menon, MD; Michael J. Morris, MD;
Matthew Puc, MD; Karen B. Russell, MD; Dimpy P. Shah, MD, PhD; Neil J. Shah, MD; Nima Sharifi, MD; Justin Shaya, MD; Michael T. Schweizer, MD; John Steinharter, MD;
Elizabeth M. Wulff-Burchfield, MD; Wenxin Xu, MD; Jay Zhu, PhD; Sanjay Mishra, PhD; Petros Grivas, PhD; Brian I. Rini, MD; Jeremy Lyle Warner, MD; Tian Zhang, MD;
Toni K. Choueiri, MD; Shilpa Gupta, MD; Rana R. McKay, MD; for the COVID-19 and Cancer Consortium
IMPORTANCE Androgen deprivation therapy (ADT) has been theorized to decrease the severity of
SARS-CoV-2 infection in patients with prostate cancer owing to a potential decrease in the tissuebased expression of the SARS-CoV-2 coreceptor transmembrane protease, serine 2 (TMPRSS2).
OBJECTIVE To examine whether ADT is associated with a decreased rate of 30-day mortality from
SARS-CoV-2 infection among patients with prostate cancer.
Question Given the higher COVID-19–
related mortality rate observed among
men than among women, is androgen
deprivation therapy associated with
decreased rate of 30-day mortality from
COVID-19 among patients with
DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed patient data recorded in the
Findings In this cohort study of 1106
COVID-19 and Cancer Consortium registry between March 17, 2020, and February 11, 2021. The
patients, no statistically significant
consortium maintains a centralized multi-institution registry of patients with a current or past
difference was found in the rates of all
diagnosis of cancer who developed COVID-19. Data were collected and managed using REDCap
cause 30-day mortality following
software hosted at Vanderbilt University Medical Center in Nashville, Tennessee. Initially, 1228
COVID-19 infection among men with
patients aged 18 years or older with prostate cancer listed as their primary malignant neoplasm were
prostate cancer receiving androgen
included; 122 patients with a second malignant neoplasm, insufficient follow-up, or low-quality data
deprivation therapy (15%) vs those not
were excluded. Propensity matching was performed using the nearest-neighbor method with a 1:3
receiving androgen deprivation
ratio of treated units to control units, adjusted for age, body mass index, race and ethnicity, Eastern
Cooperative Oncology Group performance status score, smoking status, comorbidities
Meaning The findings of this cohort
(cardiovascular, pulmonary, kidney disease, and diabetes), cancer status, baseline steroid use,
COVID-19 treatment, and presence of metastatic disease.
study do not support an association
between androgen deprivation therapy
and 30-day mortality among patients
EXPOSURES Androgen deprivation therapy use was defined as prior bilateral orchiectomy or
with COVID-19 infection.
pharmacologic ADT administered within the prior 3 months of presentation with..
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