Incidence and outcomes of severe acute respiratory syndrome coronavirus 2 infection in patients with metastatic castration-resistant prostate cancer.

Patients with cancer are at increased risk of complicated severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, but it is still unclear if the risk of mortality is influenced by cancer type or ongoing anti-cancer treatments. An interesting debate concerning the potential relationship between androgen deprivation therapy (ADT) and SARS-CoV-2 infection has recently been opened in the case of prostate cancer (PC), and the aim of this multi-centre cohort study was to investigate the incidence and outcomes of SARS-CoV-2 infection in patients with metastatic castration-resistant prostrate cancer (mCRPC).

We retrospectively reviewed the clinical records of patients with mCRPC who developed SARS-CoV-2 infection, and recorded their baseline clinical characteristics, their history of PC and SARS-CoV-2 infection, and their oncological status and treatment at the time of infection. The primary study end point was the death rate and the possible impact of the patients' PC-related history and treatments on mortality.

Thirty-four of the 1433 patients with mCRPC attending the participating centres (2.3%) developed SARS-CoV-2 infection, 22 (64.7%) of whom were hospitalised. Most of the patients were symptomatic, the most frequent symptoms being fever (70.6%), dyspnoea (61.8%), cough (52.9%) and fatigue (38.2%). After a median follow-up of 21 days (interquartile range: 13-41), 13 patients had died (38.2%), 17 recovered (50.0%) and four (11.7%) were still infected. The number of treatments previously administered for mCRPC had a significant impact on mortality (p = 0.004).

Our findings contribute additional data to the current debate concerning the postulated protective role of ADT, which seems to be less in patients with metastatic PC.

European journal of cancer (Oxford, England : 1990). 2020 Oct 19 [Epub ahead of print]

Orazio Caffo, Donatello Gasparro, Giuseppe Di Lorenzo, Alberto Dalla Volta, Pamela Guglielmini, Paolo Zucali, Roberto Bortolus, Alessia Cavo, Giovanni Ceresoli, Rita Chiari, Giuseppe Fornarini, Lucia Fratino, Alessandro Iaculli, Marco Maruzzo, Cristina Masini, Franco Morelli, Claudia Mucciarini, Giuseppe Procopio, Roberto Sabbatini, Elena Verri, Stefania Kinspergher, Francesca Maines, Carlo Messina, Antonello Veccia, Maddalena Donini

Medical Oncology Department, Santa Chiara Hospital, Largo Medaglie D'Oro, 38122, Trento, Italy. Electronic address: ., Medical Oncology Unit, University Hospital of Parma, Viale Gramsci 14, 43126, Parma, Italy., Medical Oncology Department, Tortora Hospital, Via de Gasperi 59, 84016, Pagani, Italy., Medical Oncology Unit, University of Brescia at ASST Spedali Civili, Piazzale Spedali Civili 31, 25123, Brescia, Italy., Medical Oncology Unit, SS. Antonio e Biagio e Cesare Arrigo Hospital, Via Venezia 16, 15121, Alessandria, Italy., Department of Oncology, Humanitas Clinical and Research Center, IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy., Department of Radiation Oncology, Centro di Riferimento Oncologico di Aviano CRO-IRCCS, Via Franco Gallini 2, 33081, Aviano, Italy., Oncology Unit, Villa Scassi Hospital, Corso Onofrio Scassi 1, 16149, Genoa, Italy., Thoracic and Urological Oncology Unit, Humanitas Gavazzeni Clinic, Via Mauro Gavazzeni 21, 24125, Bergamo, Italy., Oncology Unit, Immacolata Concezione Hospital, Via S. Rocco 8, 35028, Piove di Sacco, Italy., Medical Oncology Department, IRCCS Azienda Ospedaliera Universitaria San Martino, IST Istituto Nazionale per La Ricerca Sul Cancro, Largo Benzi 10, 16132, Genova, Italy., Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano CRO-IRCCS, Via Franco Gallini 2, 33081, Aviano, Italy., Medical Oncology Unit, Bolognini Hospital, Via Paderno 21, 24068, Seriate, Italy., Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS Via Gattamelata 64, 35128, Padua, Italy., Medical Oncology Unit, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia Azienda USL, IRCCS di Reggio Emilia, Reggio Emilia, Italy., Medical Oncology Department, Casa Sollievo Della Sofferenza Hospital, IRCCS, Viale Cappuccini 1, 71013, San Giovanni Rotondo, Italy., Medical Oncology Department, Ramazzini Hospital, Via Guido Molinari 2, 41012, Carpi, Italy., Genito-Urinary Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori of Milan, Via Venezian 1, 20133, Milan, Italy., Medical Oncology Unit, University Hospital of Modena, Largo Del Pozzo 71, 41125, Modena, Italy., Medical Oncology Division of Urogenital and Head & Neck Tumours, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy., Medical Oncology Department, Santa Chiara Hospital, Largo Medaglie D'Oro, 38122, Trento, Italy., Medical Oncology Department, ASST Cremona, Viale Concordia 1, 26100, Cremona, Italy.