key: cord-1011411-vhs1jidd
authors: Kwon, D. H.; Vashisht, R.; Borno, H. T.; Aggarwal, R. R.; Small, E. J.; Butte, A. J.; Huang, F. W.
title: Androgen deprivation therapy and SARS-CoV-2 in men with prostate cancer: findings from the University of California Health System registry
date: 2021-02-08
journal: Ann Oncol
DOI: 10.1016/j.annonc.2021.01.067
sha: 9cd39847dc272efd2300654128e4342283cbf6b4
doc_id: 1011411
cord_uid: vhs1jidd

nan

We read with great interest two studies on the association of androgen deprivation therapy (ADT), a widespread therapy for advanced prostate cancer, and COVID-19 published in the Annals. 1,2 SARS-CoV-2 entry into host cells is facilitated by the transmembrane protease TMPRSS2, whose expression can be modulated by the androgen receptor. 3 Pre-clinical data suggests that ADT may protect from SARS-CoV-2 infection and decrease COVID-19 severity. 3 A registry study reported by Montopoli et al. 1 demonstrated that ADT was associated with decreased COVID-19 incidence in Venetian men with prostate cancer. However, this relationship was not observed by Koskinen et al. 2 in a study of Finnish men. This relationship has not been examined in a diverse population.

We sought to determine the association between ADT and COVID-19 incidence in men with Multivariable logistic regression revealed that ADT was not independently associated with SARS-CoV-2 infection (Table 1) . By contrast, known risk factors (diabetes, Black race, Other/Multiple race, and Hispanic/Latinx ethnicity) were associated with infection.

Among 97 COVID-positive men with prostate cancer, 1/19 men (5.3%) who received ADT died, versus 7/78 men who did not (9.0%) (OR 0.56, 95%CI 0.07-4.88, P=0.60).

Our results do not suggest a benefit of ADT for SARS-CoV-2 infection or mortality, though deaths were few. Differences between our study and those in Italy and Finland are exclusion of oral anti-androgen therapies and COVID-19 community prevalence. Other factors such as socioeconomic determinants, stage, chemotherapy use, and ADT duration are unreported potential confounders. ADT duration may be important, as Patel et al. 5 recently reported that longer ADT duration was associated with decreased mortality.

In conclusion, no association between ADT and SARS-CoV-2 infection was identified in this large, diverse population of men with prostate cancer. Racial/ethnic disparities in SARS-CoV-2 infection rates described in the USA are also observed in men with prostate cancer. 

Androgen-deprivation therapies for prostate cancer and risk of infection by SARS-CoV-2: a population-based study (N = 4532)

Androgen deprivation and SARS-CoV-2 in men with prostate cancer

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Identification of antiviral antihistamines for COVID-19 repurposing

Does androgen deprivation therapy protect against severe complications from COVID-19?