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Título

ANDROGEN DEPRIVATION THERAPY REDUCES THE RISK OF INFECTION AND DEATH FROM COVID19 IN UNVACCINATED PATIENTS

Resumo

Background:
There are some conflicting data on the effect of androgen deprivation therapy
(ADT) in the course of SARS-CoV-2 infection. We assessed the incidence rate and severity of SARS-CoV-2 in patients with prostate cancer receiving ADT, with either GnRH antagonist or agonist, before vaccination for COVID19. These data were compared with the incidence and mortality in the general population (without ADT) in this same geographic area and time.
Methods:
A retrospective cohort of 103 patients from a single institution was carried out, using medical records and telephone or in-person interviews. Data were collected between
march/2020 (month of the first case of COVID-19 in the city) and march/2021.
We also collected data from the public registry on the incidence and mortality of COVID19 from male patients over 50 years of age without ADT exposure (183.980 patients).
Results:
We gathered data from 103 patients on ADT. The incidence of COVID-19 infection in men over 50 years old with and without the use of ADT from March 2020 to March 2021 was 18.4% and 25.8%, respectively. The mortality rate in the general male population over 50 years of age was 7.71%, and 5.26% in those patients using ADT.
Of the 19 patients who had COVID-19 infection, 15 had the mild form (78.9%), with no need for oxygen supplementation. Two patients (10.5%) had moderate symptoms with indication for non-invasive oxygen supplementation and others two patients (10.5%) required orotracheal intubation and mechanical ventilation, one of which died.
Among the infected patients, there were two patients aged 50-60 years, eight patients aged 60-70 years and nine patients aged over 70 years. All patients with moderate to severe symptoms were older than 60 years in this series.
Conclusions:
In our series, we had a lower incidence of COVID-19 in patients older than 50 years with prostate cancer receiving ADT compared to the general population of age-matched males. The use of ADT showed a 28.7% reduction in the incidence of COVID-19 infection. We also collected data on deaths from patients infected with or without ADT use, with a 32% reduction in mortality rates in patients undergoing hormone deprivation therapy.
Thus, our data suggest that ADT can protect prostate cancer patients against COVID19 infection as well as reduce SARS-CoV-2 mortality.

Palavras Chave

COVID-19, SARS-COV, ADT, PROSTATE CANCER

Área

Câncer de próstata metastático

Instituições

LACOG-GU - São Paulo - Brasil, ONCOCLINICAS - Distrito Federal - Brasil

Autores

PAULO SERGIO MORAES LAGES, MICHELLE SILVA BARBOSA, MARIA FERNANDA INOCENTE PINHEIRO, GIANCARLO CASTRO DOURADO PINEZI, ANDREY SOARES, LUCIANA CASTRO DOURADO LAGES, DIOGO AUGUSTO ROSA, DANIEL VARGAS PIVATO ALMEIDA, CRISTIANO RESENDE ANDRADE RESENDE