Abstract: JNCI Cancer Spectrum (2022) 6(3): pkac035 https://doi.org/10.1093/jncics/pkac035 First published online May 12, 2022 Article The Impact of Androgen Deprivation Therapy on COVID-19 Illness in Men With Prostate Cancer ,1,2,‡ Vaibhav G. Patel, MD 6 3 , Qian Qin, MD, George Mellgard, BA 2 Jones T. Nauseef, MD 3 , Himanshu Joshi, PhD 2 , David A. Green, MD, Panagiotis J. Vlachostergios, MD, PhD 7 3 2 Franklin Huang, MD, Bobby Liaw, MD, Scott Tagawa, MD William K. Oh, MD ,3 Luis Pina, MD,4 ,4 Emily Lin, MD,5 Benjamin A. Gartrell, MD,5 Victor Adorno Febles, MD Jessica E. Hawley, MD David R. Wise, MD ,3,‡ Xiaobo Zhong, DrPD 3, , Philip Kantoff, MD, 1,2 , ,6 3 ,2 Daniel H. Kwon, MD,7 Michael J. Morris, MD,1,2 * 1 Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; 2Department of Medicine, Weill Cornell Medical Center, New York, NY, USA; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 4Department of Medicine, Columbia University Medical Center, New York, NY, USA; 5Department of Medicine, Montefiore Center for Cancer Care, Bronx, NY, USA; 6Department of Medicine, NYU Langone Medical Center, New York, NY, USA and 7 Department of Medicine, University of California, San Francisco, CA, USA 3 ‡ These authors contributed equally. *Correspondence to: William K. Oh, MD, Clinical Professor of Medicine, Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Pl, Box 1128, New York, NY 10029, USA (e-mail: william.oh@mssm.edu). Abstract Background: TMPRSS2, a cell surface protease regulated by androgens and commonly upregulated in prostate cancer (PCa), is a necessary component for SARS-CoV-2 viral entry into respiratory epithelial cells. Previous reports suggested a lower risk of SARS-CoV-2 among PCa patients on androgen deprivation therapy (ADT). However, the impact of ADT on severe COVID-19 illness is poorly understood. Methods: We performed a multicenter study across 7 US medical centers and evaluated patients with PCa and SARS-CoV-2 detected by polymerase-chain-reaction between March 1, 2020, and May 31, 2020. PCa patients were considered on ADT if they had received appropriate ADT treatment within 6 months of COVID-19 diagnosis. We used multivariable logistic and Cox proportional-hazard regression models for analysis. All statistical tests were 2-sided. Results: We identified 465 PCa patients (median age ¼ 71 years) with a median follow-up of 60 days. Age, body mass index, cardiovascular comorbidity, and PCa clinical disease state adjusted overall survival (hazard ratio [HR] ¼ 1.16, 95% confidence interval [CI] ¼ 0.68 to 1.98, P ¼ .59), hospitalization status (HR ¼ 0.96, 95% CI ¼ 0.52 to 1.77, P ¼ .90), supplemental oxygenation (HR 1.14, 95% CI ¼ 0.66 to 1.99, P ¼ .64), and use of mechanical ventilation (HR ¼ 0.81, 95% CI ¼ 0.25 to 2.66, P ¼ .73) were similar between ADT and non-ADT cohorts. Similarly, the addition of androgen receptor–directed therapy within 30 days of COVID-19 diagnosis to ADT vs ADT alone did not statistically significantly affect overall survival (androgen receptor–directed therapy: HR ¼ 1.27, 95% CI ¼ 0.69 to 2.32, P ¼ .44). Conclusions: In this retrospective cohort of PCa patients, the use of ADT was not demonstrated to influence severe COVID-19 outcomes, as defined by hospitalization, supplemental oxygen use, or death. Age 70 years and older was statistically..