Androgen Deprivation Therapy in Men with Prostate Cancer Does Not Affect Risk of Infection with SARS-CoV-2
Androgen Deprivation Therapy in Men with Prostate Cancer Does Not Affect Risk of Infection with SARS-CoV-2
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DOI：
10.1097/ju.0000000000001338
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发表时间：
2021-02-01
影响因子：
6.6
通讯作者：
Jehi, Lara
中科院分区：
文献类型：
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作者：
Klein, Eric A.;Li, Jianbo;Jehi, Lara
目的：TMPRSS2 是 SARS-CoV-2 进入细胞的宿主共受体。先前的一份报告表明，使用下调 TMPRSS2 的雄激素剥夺疗法可以保护患有前列腺癌的男性免受感染。 材料和方法：这是一项前瞻性登记研究，对 2020 年 3 月 12 日至 6 月 10 日期间接受过 SARS-CoV-2 检测的所有患者进行前瞻性登记，并进行完整随访，直至疾病康复或死亡。检查的主要暴露是雄激素剥夺疗法的使用，结果指标是 SARS-CoV-2 阳性率和疾病严重程度与雄激素剥夺疗法使用的关系。 结果：研究队列由 74,787 名测试人群中的 1,779 名前列腺癌男性组成，其中 4,885 名 (6.5%) SARS-CoV-2 呈阳性。在前列腺癌患者中，102 例 (5.7%) 呈 SARS-CoV-2 阳性，304 例 (17.1%) 正在接受雄激素剥夺治疗。在接受雄激素剥夺治疗的患者中，5.6% 呈阳性，而未接受雄激素剥夺治疗的患者中有 5.8% 呈阳性。接受雄激素剥夺治疗的男性年龄稍大（75.5 岁 vs 73.8 岁，p = 0.009），更有可能吸烟（68.1% vs 59.3%，p = 0.005），并且更有可能服用类固醇（43.8% vs 23.3%，p < 0.001）。其他已知会增加感染风险和疾病严重程度的因素分布均匀（哮喘、糖尿病、高血压、冠状动脉疾病、心力衰竭和免疫抑制疾病）。多变量分析并未表明接受雄激素剥夺疗法的前列腺癌患者的感染风险存在差异（OR 0.93，95% CI 0.54-1.61，p=0.8）。结论：雄激素剥夺疗法似乎不能预防 SARS-CoV-2 感染。
Purpose: TMPRSS2 is a host co-receptor for cell entry of SARS-CoV-2. A prior report suggested that use of androgen deprivation therapy, which downregulates TMPRSS2, may protect men with prostate cancer from infection.Materials and Methods: This is a cohort study of a prospective registry of all patients tested for SARS-CoV-2 between March 12 and June 10, 2020 with complete followup until disease recovery or death. The main exposure examined was the use of androgen deprivation therapy, and the outcome measures were the rate of SARS-CoV-2 positivity and disease severity as a function of androgen deprivation therapy use.Results: 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 androgen deprivation therapy. Among those on androgen deprivation therapy 5.6% were positive as compared to 5.8% not on androgen deprivation therapy. Men on androgen deprivation therapy were slightly older (75.5 vs 73.8 years, p = 0.009), more likely to have smoked (68.1% vs 59.3%, p = 0.005) and more likely to report taking steroids (43.8% vs 23.3%, p < 0.001). Other factors known to increase 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 androgen deprivation therapy (OR 0.93, 95% CI 0.54-1.61, p=0.8).Conclusions: Androgen deprivation therapy does not appear to be protective against SARS-CoV-2 infection.