Susceptibility to SARS-Cov-2 Infection and Risk for Severe COVID-19 in Patients with Prostate Cancer on Androgen Deprivation Therapy

Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée au COVID-19

Résumé en anglais

Androgen deprivation therapy (ADT) has been hypothesized to protect against COVID-19, but previous observational studies of men with prostate cancer on ADT have been inconsistent regarding mortality risk from coronavirus disease 2019 (COVID-19). Using data from the Prostate Cancer data Base Sweden (PCBaSe), we identified a cohort of 114 547 men with prevalent prostate cancer on the start of follow-up in February 2020, and followed them until 16 December 2020 to evaluate the association between ADT and time to test positive for COVID-19. Among men testing positive for COVID-19, we used regression analyses to estimate the association between ADT and risk of COVID-19-related hospital admission/death from any cause within 30 days of the positive test. In total, 1695 men with prostate cancer tested positive for COVID-19. In crude analyses, exposure to ADT was associated with a three-fold increased risk of both testing positive for COVID-19 infection and subsequent hospital admission/death. Adjustment for age, comorbidity, and prostate cancer risk category substantially attenuated the associations: HR 1.3 (95% CI: 1.1–1.5) for testing positive for COVID-19, and OR 1.4 (95% CI: 1.0–1.9) for risk of subsequent hospital admission/death. In conclusion, although these results suggest increased risks of a positive COVID-19 test, and COVID-19-related hospital admission/death in men on ADT, these findings are likely explained by confounding by old age, cancer-associated morbidity, and other comorbidities being more prevalent in men on ADT, rather than a direct effect of the therapy. This article is protected by copyright. All rights reserved.