Association Between Androgen Deprivation Therapy and Mortality Among Patients With Prostate Cancer and COVID-19
Retrospective 1,106 prostate cancer patients, showing higher mortality with HCQ treatment.
risk of death, 333.0% higher, OR 4.33, p < 0.001, treatment 70, control 407, adjusted per study, propensity score matching, multivariable, RR approximated with OR, excluded in exclusion analyses:
confounding by indication is likely and adjustments do not consider COVID-19 severity at baseline.
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risk of severe case, 613.0% higher, OR 7.13, p < 0.001, treatment 70, control 407, adjusted per study, propensity score matching, multivariable, RR approximated with OR, excluded in exclusion analyses:
confounding by indication is likely and adjustments do not consider COVID-19 severity at baseline.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Schmidt et al., 12 Nov 2021, retrospective, USA, peer-reviewed, 42 authors, study period 17 March, 2020 - 11 February, 2021.
Abstract: Original Investigation | Urology
Association Between Androgen Deprivation Therapy and Mortality
Among Patients With Prostate Cancer and COVID-19
Andrew L. Schmidt, MD; Matthew D. Tucker, MD; Ziad Bakouny, MD; Chris Labaki, MD; Chih-Yuan Hsu, PhD; Yu Shyr, PhD; Andrew J. Armstrong, MD; Tomasz M. Beer, MD;
Ragneel R. Bijjula, MD; Mehmet A. Bilen, MD; Cindy F. Connell, MD, PhD; Scott Joseph Dawsey, MD; Bryan Faller, MD; Xin Gao, MD; Benjamin A. Gartrell, MD;
David Gill, MD; Shuchi Gulati, MD; Susan Halabi, PhD; Clara Hwang, MD; Monika Joshi, MD; Ali Raza Khaki, MD; Harry Menon, MD; Michael J. Morris, MD;
Matthew Puc, MD; Karen B. Russell, MD; Dimpy P. Shah, MD, PhD; Neil J. Shah, MD; Nima Sharifi, MD; Justin Shaya, MD; Michael T. Schweizer, MD; John Steinharter, MD;
Elizabeth M. Wulff-Burchfield, MD; Wenxin Xu, MD; Jay Zhu, PhD; Sanjay Mishra, PhD; Petros Grivas, PhD; Brian I. Rini, MD; Jeremy Lyle Warner, MD; Tian Zhang, MD;
Toni K. Choueiri, MD; Shilpa Gupta, MD; Rana R. McKay, MD; for the COVID-19 and Cancer Consortium
Abstract
Key Points
IMPORTANCE Androgen deprivation therapy (ADT) has been theorized to decrease the severity of
SARS-CoV-2 infection in patients with prostate cancer owing to a potential decrease in the tissuebased expression of the SARS-CoV-2 coreceptor transmembrane protease, serine 2 (TMPRSS2).
OBJECTIVE To examine whether ADT is associated with a decreased rate of 30-day mortality from
SARS-CoV-2 infection among patients with prostate cancer.
Question Given the higher COVID-19–
related mortality rate observed among
men than among women, is androgen
deprivation therapy associated with
decreased rate of 30-day mortality from
COVID-19 among patients with
prostate cancer?
DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed patient data recorded in the
Findings In this cohort study of 1106
COVID-19 and Cancer Consortium registry between March 17, 2020, and February 11, 2021. The
patients, no statistically significant
consortium maintains a centralized multi-institution registry of patients with a current or past
difference was found in the rates of all
diagnosis of cancer who developed COVID-19. Data were collected and managed using REDCap
cause 30-day mortality following
software hosted at Vanderbilt University Medical Center in Nashville, Tennessee. Initially, 1228
COVID-19 infection among men with
patients aged 18 years or older with prostate cancer listed as their primary malignant neoplasm were
prostate cancer receiving androgen
included; 122 patients with a second malignant neoplasm, insufficient follow-up, or low-quality data
deprivation therapy (15%) vs those not
were excluded. Propensity matching was performed using the nearest-neighbor method with a 1:3
receiving androgen deprivation
ratio of treated units to control units, adjusted for age, body mass index, race and ethnicity, Eastern
therapy (14%).
Cooperative Oncology Group performance status score, smoking status, comorbidities
Meaning The findings of this cohort
(cardiovascular, pulmonary, kidney disease, and diabetes), cancer status, baseline steroid use,
COVID-19 treatment, and presence of metastatic disease.
study do not support an association
between androgen deprivation therapy
and 30-day mortality among patients
EXPOSURES Androgen deprivation therapy use was defined as prior bilateral orchiectomy or
with COVID-19 infection.
pharmacologic ADT administered within the prior 3 months of presentation with..
Late treatment
is less effective
schmidt
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