TY - JOUR
T1 - The Impact of Androgen Deprivation Therapy on COVID-19 Illness in Men With Prostate Cancer
AU - Shah, Neil J.
AU - Patel, Vaibhav G.
AU - Zhong, Xiaobo
AU - Pina, Luis
AU - Hawley, Jessica E.
AU - Lin, Emily
AU - Gartrell, Benjamin A.
AU - Febles, Victor Adorno
AU - Wise, David R.
AU - Qin, Qian
AU - Mellgard, George
AU - Joshi, Himanshu
AU - Nauseef, Jones T.
AU - Green, David A.
AU - Vlachostergios, Panagiotis J.
AU - Kwon, Daniel H.
AU - Huang, Franklin
AU - Liaw, Bobby
AU - Tagawa, Scott
AU - Kantoff, Philip
AU - Morris, Michael J.
AU - Oh, William K.
N1 - Publisher Copyright:
© The Author(s) 2022.
PY - 2022/6/1
Y1 - 2022/6/1
N2 - 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 significantly associated with a higher risk of developing severe COVID-19 disease.
AB - 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 significantly associated with a higher risk of developing severe COVID-19 disease.
UR - https://www.scopus.com/pages/publications/85141715118
UR - https://www.scopus.com/pages/publications/85141715118#tab=citedBy
U2 - 10.1093/jncics/pkac035
DO - 10.1093/jncics/pkac035
M3 - Article
C2 - 35657341
AN - SCOPUS:85141715118
SN - 2515-5091
VL - 6
JO - JNCI Cancer Spectrum
JF - JNCI Cancer Spectrum
IS - 3
M1 - pkac035
ER -
