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Androgen deprivation therapy in men with prostate cancer is not associated with COVID-2019 infection
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Urology.ORCID iD: 0000-0002-2850-6009
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Urology, Faculty of Medicine and Health, Örebro University Hospital, Örebro University, Örebro, Sweden.
Örebro University, School of Medical Sciences. Örebro University Hospital.ORCID iD: 0000-0001-9204-1165
Department of Urology, Karlstad Central Hospital, Karlstad, Sweden.
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2023 (English)In: The Prostate, ISSN 0270-4137, E-ISSN 1097-0045, Vol. 83, no 6, p. 555-562Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Androgens may play a role in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and host responses as the virus is dependent on the androgen-regulated protein transmembrane serine protease 2 for cell entry. Studies have indicated that prostate cancer patients receiving androgen deprivation therapy (ADT) are at reduced risk of SARS-CoV-2 infection and serious complications compared with patients without ADT, but data are inconsistent.

METHODS: A total of 655 prostate cancer patients who were under surveillance at two urology departments in Sweden on April 1, 2020 were included in the study as well as 240 patients with benign prostatic hyperplasia (BPH). At follow-up early in 2021, the participants completed a questionnaire containing information about symptoms compatible with coronavirus disease 2019 (COVID-19). Blood samples were also collected for the assessment of SARS-CoV-2 IgG antibodies (SARS-CoV-2 Total; Siemens). We used multivariable logistic regression models to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between ADT and the risk of SARS-CoV-2 infection.

RESULTS: The cumulative incidence of SARS-CoV-2 seropositivity was 13.4% among patients receiving ADT and 10.4% among patients without ADT. After adjusting for potential confounders, we observed no differences in symptoms or risk of SARS-CoV-2 infection between patients with and without ADT (OR: 0.98; 95% CI: 0.52-1.85). Higher body mass index, Type 1 diabetes, and prostate cancer severity, defined by high Gleason score (8-10; OR: 2.06; 95% CI: 1.04-4.09) or elevated levels of prostate-specific antigen (>20 µg/l; OR: 2.15; 95% CI: 1.13-4.07) were associated with increased risk of SARS-CoV-2 infection. Overall, the risk of SARS-CoV-2 infection was not higher among men with prostate cancer than among men with BPH.

CONCLUSIONS: Our results do not support the hypothesis that ADT use in prostate cancer patients reduces the risk or symptom severity of SARS-CoV-2 infection or that prostate cancer patients are at increased risk of COVID-19 compared with men without prostate cancer.

Place, publisher, year, edition, pages
Alan R. Liss Inc. , 2023. Vol. 83, no 6, p. 555-562
Keywords [en]
COVID-19, SARS-CoV-2, androgen deprivation therapy, prostate cancer
National Category
Infectious Medicine Urology and Nephrology Cancer and Oncology
Identifiers
URN: urn:nbn:se:oru:diva-103314DOI: 10.1002/pros.24485ISI: 000915900700001PubMedID: 36658755Scopus ID: 2-s2.0-85147012865OAI: oai:DiVA.org:oru-103314DiVA, id: diva2:1731182
Funder
Prostatacancerförbundet
Note

Funding agency:

Örebro County Research Foundation

Available from: 2023-01-26 Created: 2023-01-26 Last updated: 2024-10-09Bibliographically approved

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Davidsson, SabinaMessing Eriksson, AnnaUdumyan, RuzanFall, Katja

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