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The Impact of Androgen Deprivation Therapy on COVID-19 Illness in Men With Prostate Cancer

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 deprivati...

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Autores principales: Shah, Neil J, Patel, Vaibhav G, Zhong, Xiaobo, Pina, Luis, Hawley, Jessica E, Lin, Emily, Gartrell, Benjamin A, Febles, Victor Adorno, Wise, David R, Qin, Qian, Mellgard, George, Joshi, Himanshu, Nauseef, Jones T, Green, David A, Vlachostergios, Panagiotis J, Kwon, Daniel H, Huang, Franklin, Liaw, Bobby, Tagawa, Scott, Kantoff, Philip, Morris, Michael J, Oh, William K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9165550/
https://www.ncbi.nlm.nih.gov/pubmed/35657341
http://dx.doi.org/10.1093/jncics/pkac035
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author Shah, Neil J
Patel, Vaibhav G
Zhong, Xiaobo
Pina, Luis
Hawley, Jessica E
Lin, Emily
Gartrell, Benjamin A
Febles, Victor Adorno
Wise, David R
Qin, Qian
Mellgard, George
Joshi, Himanshu
Nauseef, Jones T
Green, David A
Vlachostergios, Panagiotis J
Kwon, Daniel H
Huang, Franklin
Liaw, Bobby
Tagawa, Scott
Kantoff, Philip
Morris, Michael J
Oh, William K
author_facet Shah, Neil J
Patel, Vaibhav G
Zhong, Xiaobo
Pina, Luis
Hawley, Jessica E
Lin, Emily
Gartrell, Benjamin A
Febles, Victor Adorno
Wise, David R
Qin, Qian
Mellgard, George
Joshi, Himanshu
Nauseef, Jones T
Green, David A
Vlachostergios, Panagiotis J
Kwon, Daniel H
Huang, Franklin
Liaw, Bobby
Tagawa, Scott
Kantoff, Philip
Morris, Michael J
Oh, William K
author_sort Shah, Neil J
collection PubMed
description 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 = 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] = 1.16, 95% confidence interval [CI] = 0.68 to 1.98, P = .59), hospitalization status (HR = 0.96, 95% CI = 0.52 to 1.77, P = .90), supplemental oxygenation (HR 1.14, 95% CI = 0.66 to 1.99, P = .64), and use of mechanical ventilation (HR = 0.81, 95% CI = 0.25 to 2.66, P = .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 = 1.27, 95% CI = 0.69 to 2.32, P = .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.
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spelling pubmed-91655502022-06-06 The Impact of Androgen Deprivation Therapy on COVID-19 Illness in Men With Prostate Cancer Shah, Neil J Patel, Vaibhav G Zhong, Xiaobo Pina, Luis Hawley, Jessica E Lin, Emily Gartrell, Benjamin A Febles, Victor Adorno Wise, David R Qin, Qian Mellgard, George Joshi, Himanshu Nauseef, Jones T Green, David A Vlachostergios, Panagiotis J Kwon, Daniel H Huang, Franklin Liaw, Bobby Tagawa, Scott Kantoff, Philip Morris, Michael J Oh, William K JNCI Cancer Spectr Article 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 = 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] = 1.16, 95% confidence interval [CI] = 0.68 to 1.98, P = .59), hospitalization status (HR = 0.96, 95% CI = 0.52 to 1.77, P = .90), supplemental oxygenation (HR 1.14, 95% CI = 0.66 to 1.99, P = .64), and use of mechanical ventilation (HR = 0.81, 95% CI = 0.25 to 2.66, P = .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 = 1.27, 95% CI = 0.69 to 2.32, P = .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. Oxford University Press 2022-05-12 /pmc/articles/PMC9165550/ /pubmed/35657341 http://dx.doi.org/10.1093/jncics/pkac035 Text en © The Author(s) 2022. Published by Oxford University Press. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Article
Shah, Neil J
Patel, Vaibhav G
Zhong, Xiaobo
Pina, Luis
Hawley, Jessica E
Lin, Emily
Gartrell, Benjamin A
Febles, Victor Adorno
Wise, David R
Qin, Qian
Mellgard, George
Joshi, Himanshu
Nauseef, Jones T
Green, David A
Vlachostergios, Panagiotis J
Kwon, Daniel H
Huang, Franklin
Liaw, Bobby
Tagawa, Scott
Kantoff, Philip
Morris, Michael J
Oh, William K
The Impact of Androgen Deprivation Therapy on COVID-19 Illness in Men With Prostate Cancer
title The Impact of Androgen Deprivation Therapy on COVID-19 Illness in Men With Prostate Cancer
title_full The Impact of Androgen Deprivation Therapy on COVID-19 Illness in Men With Prostate Cancer
title_fullStr The Impact of Androgen Deprivation Therapy on COVID-19 Illness in Men With Prostate Cancer
title_full_unstemmed The Impact of Androgen Deprivation Therapy on COVID-19 Illness in Men With Prostate Cancer
title_short The Impact of Androgen Deprivation Therapy on COVID-19 Illness in Men With Prostate Cancer
title_sort impact of androgen deprivation therapy on covid-19 illness in men with prostate cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9165550/
https://www.ncbi.nlm.nih.gov/pubmed/35657341
http://dx.doi.org/10.1093/jncics/pkac035
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