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29-07-2020 | Oncology | News | Article

ADT tied to reduced COVID-19 severity

medwireNews: Receipt of androgen deprivation therapy (ADT) may be associated with less severe COVID-19 outcomes, suggest data from New York City.

These findings follow three previous reports, one of which – from the Veneto region in northern Italy – indicated a link between ADT and reduced risk for SARS-CoV-2 infection, while the other two studies – from northern Italy and Finland – found no such association.

The investigators of the current study explain that “SARS-CoV-2 relies on surface expression of ACE2 and TMPRSS2 for cellular entry and replication in the respiratory epithelium,” and add that TMPRSS2 “is known to be regulated by androgens.”

Therefore, ADT “may theoretically reduce TMPRSS2 expression limiting SARS-CoV-2 cellular entry and preventing severe complications from COVID-19,” the team writes in a letter to the Annals of Oncology.

William Oh and colleagues, from the Icahn School of Medicine at Mount Sinai in New York, USA, queried the records at their institution to identify 58 men with prostate cancer who received a laboratory-confirmed diagnosis of COVID-19 between 1 March and 6 April, 2020.

Of these, 22 had received ADT, which was defined as treatment with a gonadotropin-releasing hormone analog or antagonist within 3 months and/or testosterone levels at or below 50 ng/dL within 6 months of the COVID-19 diagnosis.

After adjusting for age, cardiac disease, and pulmonary disease, receipt of ADT was associated with significantly reduced risks for hospitalization and the need for supplemental oxygen, at odds ratios (OR) of 0.23 and 0.26, respectively.

ADT use also appeared to reduce the risks for intubation (OR=0.31) and mortality (OR=0.37), but these associations did not reach statistical significance.

“Despite the limitations of a small sample size, our data supports the hypothesis that ADT may limit severe complications from COVID-19,” say Oh and co-authors, who “aim to develop a larger multi-institution dataset” to validate these findings.

And the team concludes: “Additionally, a prospective clinical trial is warranted to answer this important clinical question.”

medwireNews is an independent medical news service provided by Springer Healthcare. © 2020 Springer Healthcare part of the Springer Nature Group

29 July 2020: The coronavirus pandemic is affecting all healthcare professionals across the globe. Medicine Matters’ focus, in this difficult time, is the dissemination of the latest data to support you in your research and clinical practice, based on the scientific literature. We will update the information we provide on the site, as the data are published. However, please refer to your own professional and governmental guidelines for the latest guidance in your own country.

Ann Oncol 2020; doi:10.1016/j.annonc.2020.06.023

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