Androgen Deprivation Therapy May Protect Against COVID-19 in
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Cell entry of SARS-CoV-2 depends on binding of the viral spike (S) proteins to angiotensin-converting enzyme 2 and on S protein priming by TMPRSS2. Inhibition of TMPRSS2 may work to block or decrease the severity of SARS-CoV-2 infections.

Intriguingly, TMPRSS2 is an androgen-regulated gene that is up-regulated in prostate cancer where it supports tumor progression and is involved in a frequent genetic translocation with the ERG gene. First- or second-generation androgen-deprivation therapies (ADTs) decrease the levels of TMPRSS2. Researchers put forward the hypothesis that ADTs may protect patients affected by prostate cancer from SARS-CoV-2 infections.

Researchers extracted data regarding 9280 patients (4532 males) with laboratory-confirmed SARS-CoV-2 infection from 68 hospitals in Veneto, one of the Italian regions that was most affected by COVID-19 pandemic. The parameters used for each COVID-19-positive patient were sex, hospitalization, admission to intensive care unit, death, tumor diagnosis, prostate cancer diagnosis, and ADT.

Results:
-- There were evaluable 9280 SARS-CoV-2-positive patients, Overall, males developed more severe complications, were more frequently hospitalized, and had a worse clinical outcome than females.
-- Considering only the Veneto male population (2.4 million men), 0.2% and 0.3% of non-cancer and cancer patients, respectively, tested positive for SARS-CoV-2.
-- Comparing the total number of SARS-CoV-2-positive cases, prostate cancer patients receiving ADT had a significantly lower risk of SARS-CoV-2 infection compared with patients who did not receive ADT.
-- A greater difference was found comparing prostate cancer patients receiving ADT with patients with any other type of cancer.

Conclusively, this data suggest that cancer patients have an increased risk of SARS-CoV-2 infections compared with non-cancer patients. However, prostate cancer patients receiving ADT appear to be partially protected from SARS-CoV-2 infections.

Source: https://www.annalsofoncology.org/article/S0923-7534(20)39797-0/fulltext
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