Androgen deprivation therapy and excess mortality in men with prostate cancer during the initial phase of the COVID-19 pandemic.

<h4>Background</h4>Men have a higher risk of death from COVID-19 than women and androgens facilitate entrance of the SARS-CoV-2 virus into respiratory epithelial cells. Thus, androgen deprivation therapy may reduce infection rates and improve outcomes for COVID-19. In the spring of 2020,...

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Autores principales:	Rolf Gedeborg, Johan Styrke, Stacy Loeb, Hans Garmo, Pär Stattin
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a67848ce438c4c64b9b793a6a0dd2fe5
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spelling	oai:doaj.org-article:a67848ce438c4c64b9b793a6a0dd2fe52021-11-25T05:54:13ZAndrogen deprivation therapy and excess mortality in men with prostate cancer during the initial phase of the COVID-19 pandemic.1932-620310.1371/journal.pone.0255966https://doaj.org/article/a67848ce438c4c64b9b793a6a0dd2fe52021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255966https://doaj.org/toc/1932-6203<h4>Background</h4>Men have a higher risk of death from COVID-19 than women and androgens facilitate entrance of the SARS-CoV-2 virus into respiratory epithelial cells. Thus, androgen deprivation therapy may reduce infection rates and improve outcomes for COVID-19. In the spring of 2020, Sweden was highly affected by COVID-19. The aim was to estimate the impact of androgen deprivation therapy on mortality from COVID-19 in men with prevalent prostate cancer by comparing all-cause mortality in the spring of 2020 to that in previous years.<h4>Patients and methods</h4>Using the Prostate Cancer data Base Sweden all men with prostate cancer on March 1 each year in 2015-2020 were followed until June 30 the same year. Exposure to androgen deprivation therapy was ascertained from filled prescriptions for bicalutamide monotherapy, gonadotropin-releasing hormone agonists (GnRH), or bilateral orchidectomy.<h4>Results</h4>A total of 9,822 men died in March-June in the years 2015-2020, of whom 5,034 men were on androgen deprivation therapy. There was an excess mortality in 2020 vs previous years in all men. The crude relative mortality rate ratio for 2020 vs 2015-2019 was 0.93 (95% confidence interval (CI) 0.83 to 1.04) in men on GnRH, and 0.90 (95% CI 0.78 to 1.05) in men on bicalutamide monotherapy. After multivariable adjustment these ratios were attenuated to 1.00 (95% CI 0.89 to 1.12) and 0.97 (95% CI 0.84 to 1.12), respectively. When restricting the analysis to the regions with the highest incidence of COVID-19 or to the time period between 2 April to 10 June when mortality in 2020 was increased >30% compared to previous years, the results were similar to the main analysis.<h4>Conclusions</h4>In this large national population-based cohort of men with prevalent prostate cancer, there was no clear evidence in support for an effect of androgen deprivation therapy on COVID-19 mortality.Rolf GedeborgJohan StyrkeStacy LoebHans GarmoPär StattinPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0255966 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Rolf Gedeborg Johan Styrke Stacy Loeb Hans Garmo Pär Stattin Androgen deprivation therapy and excess mortality in men with prostate cancer during the initial phase of the COVID-19 pandemic.
description	<h4>Background</h4>Men have a higher risk of death from COVID-19 than women and androgens facilitate entrance of the SARS-CoV-2 virus into respiratory epithelial cells. Thus, androgen deprivation therapy may reduce infection rates and improve outcomes for COVID-19. In the spring of 2020, Sweden was highly affected by COVID-19. The aim was to estimate the impact of androgen deprivation therapy on mortality from COVID-19 in men with prevalent prostate cancer by comparing all-cause mortality in the spring of 2020 to that in previous years.<h4>Patients and methods</h4>Using the Prostate Cancer data Base Sweden all men with prostate cancer on March 1 each year in 2015-2020 were followed until June 30 the same year. Exposure to androgen deprivation therapy was ascertained from filled prescriptions for bicalutamide monotherapy, gonadotropin-releasing hormone agonists (GnRH), or bilateral orchidectomy.<h4>Results</h4>A total of 9,822 men died in March-June in the years 2015-2020, of whom 5,034 men were on androgen deprivation therapy. There was an excess mortality in 2020 vs previous years in all men. The crude relative mortality rate ratio for 2020 vs 2015-2019 was 0.93 (95% confidence interval (CI) 0.83 to 1.04) in men on GnRH, and 0.90 (95% CI 0.78 to 1.05) in men on bicalutamide monotherapy. After multivariable adjustment these ratios were attenuated to 1.00 (95% CI 0.89 to 1.12) and 0.97 (95% CI 0.84 to 1.12), respectively. When restricting the analysis to the regions with the highest incidence of COVID-19 or to the time period between 2 April to 10 June when mortality in 2020 was increased >30% compared to previous years, the results were similar to the main analysis.<h4>Conclusions</h4>In this large national population-based cohort of men with prevalent prostate cancer, there was no clear evidence in support for an effect of androgen deprivation therapy on COVID-19 mortality.
format	article
author	Rolf Gedeborg Johan Styrke Stacy Loeb Hans Garmo Pär Stattin
author_facet	Rolf Gedeborg Johan Styrke Stacy Loeb Hans Garmo Pär Stattin
author_sort	Rolf Gedeborg
title	Androgen deprivation therapy and excess mortality in men with prostate cancer during the initial phase of the COVID-19 pandemic.
title_short	Androgen deprivation therapy and excess mortality in men with prostate cancer during the initial phase of the COVID-19 pandemic.
title_full	Androgen deprivation therapy and excess mortality in men with prostate cancer during the initial phase of the COVID-19 pandemic.
title_fullStr	Androgen deprivation therapy and excess mortality in men with prostate cancer during the initial phase of the COVID-19 pandemic.
title_full_unstemmed	Androgen deprivation therapy and excess mortality in men with prostate cancer during the initial phase of the COVID-19 pandemic.
title_sort	androgen deprivation therapy and excess mortality in men with prostate cancer during the initial phase of the covid-19 pandemic.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/a67848ce438c4c64b9b793a6a0dd2fe5
work_keys_str_mv	AT rolfgedeborg androgendeprivationtherapyandexcessmortalityinmenwithprostatecancerduringtheinitialphaseofthecovid19pandemic AT johanstyrke androgendeprivationtherapyandexcessmortalityinmenwithprostatecancerduringtheinitialphaseofthecovid19pandemic AT stacyloeb androgendeprivationtherapyandexcessmortalityinmenwithprostatecancerduringtheinitialphaseofthecovid19pandemic AT hansgarmo androgendeprivationtherapyandexcessmortalityinmenwithprostatecancerduringtheinitialphaseofthecovid19pandemic AT parstattin androgendeprivationtherapyandexcessmortalityinmenwithprostatecancerduringtheinitialphaseofthecovid19pandemic
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Androgen deprivation therapy and excess mortality in men with prostate cancer during the initial phase of the COVID-19 pandemic.

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