TMPRSS2 is a host co-receptor for cell entry of SARS-CoV-2. One prior report suggested that use of androgen deprivation therapy (ADT), which downregulates TMPRSS2, may protect men with prostate cancer from infection.
Cohort study of a prospective registry of all patients tested for SARS-CoV-2 between March 12 and June 10, 2020, with complete follow-up until disease recovery or death. The main exposure examined was the use of ADT, and the outcome measures were the rate of SARS-CoV-2 positivity and disease severity as a function of ADT use.
The study cohort consisted of 1,779 men with prostate cancer from a total tested population of 74,787, of whom 4,885 (6.5%) were positive for SARS-CoV-2. Of those with prostate cancer, 102 (5.7%) were SARS-CoV-2 positive and 304 (17.1%) were on ADT. Among those on ADT, 5.6% were positive as compared to 5.8% not on ADT. Men on ADT were slightly older (75.5 vs. 73.8 years, p=.009), more likely to have smoked (68.1% vs. 59.3%, p =.005), and more likely to report taking steroids (43.8% vs. 23.3%, p < .001). Other factors known to increase both risk of infection and disease severity were equally distributed (asthma, diabetes mellitus, hypertension, coronary artery disease, heart failure, and immune suppressive disease). Multivariable analysis did not indicate a difference in infection risk for those with prostate cancer on ADT (OR 0.93, 95% CI 0.54-1.61, p = 0.8).
ADT does not appear to be protective against SARS-CoV-2 infection.
The Journal of urology. 2020 Sep 08 [Epub ahead of print]
Eric A Klein, Jianbo Li, Alex Milinovich, Jesse D Schold, Nima Sharifi, Michael W Kattan, Lara Jehi
Department of Urology, Glickman Urological and Kidney Institute, Cleveland, Ohio., Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland, Ohio., Department of Cancer Biology, Lerner Research Institute, Cleveland, Ohio., Department of Neurology, Neurological Institute Cleveland Clinic and Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio.