The clinical impact of androgen deprivation therapy on SARS-CoV-2 infection rates and disease severity

Abstract

Objective: The protective effect of androgen deprivation therapy (ADT) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel hypothesis. ADT may protect patients with prostate cancer through the inhibition of androgen receptor-dependent transmembrane serine protease type 2. We analyzed the role of ADT on SARS-CoV-2 infection risk and disease severity. Material and methods: Between August 2020 and June 2021, patients with prostate cancer were included in our study. Patients were divided into two groups as men receiving ADT or not. Patients' characteristics such as prostate cancer grade and stage, comorbidities, SARS-CoV-2 infection status, and infection severity were assessed. SARS-CoV-2-infected close relatives and patients' compliance with the precautions against SARS-CoV-2 were also analyzed. Results: A total of 365 patients, 138 (37.8%) with ADT and 227 (62.2%) without ADT, were included in our analysis. Patients with ADT were older (71.8 vs 66.9 years, P = .001) and had a higher rate of chronic obstructive pulmonary disease (11.6% vs 5.7%, P = .044). Patients receiving ADT were more often locally advanced and metastatic (80.4% vs 32.6%, P = .001). SARS-CoV-2 infection rates were statistically similar between patients who received and did not receive ADT (9.4% vs 13.2%, P = .275, respectively). There was no significant difference between two groups in terms of hospitalization rates (2.9% vs 0.9%, P = .205). In multivariate analysis, the presence of SARS-CoV-2-infected close relatives and precautions score were only independent predictors for both risk of SARS-CoV-2 infection and infection severity. Conclusion: We could not find any effect of ADT on risk and severity of SARS-CoV-2 infection. SARS-CoV-2 infection and hospitalization rates were similar between patients with and without ADT.