Does androgen deprivation therapy protect against severe complications from COVID-19?

Patel, Vaibhav; Zhong, Xiaobo; Liaw, Bobby Chi-Hung; Tremblay, Douglas; Tsao, Che‐Kai; Galsky, Matthew D.; Oh, William

doi:10.1016/j.annonc.2020.06.023

Cited by 72 publications

(84 citation statements)

References 5 publications

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“…therapy (ADT) were less likely to be infected by SARS-CoV-2, compared with patients with prostate cancer not on ADT and with patients with other tumor types (Montopoli et al, 2020). In parallel, another retrospective study from a cancer center in the northeastern United States found that patients with prostate cancer treated with ADT were less likely to develop adverse clinical outcomes (hospitalization and oxygen supplementation), compared with those not treated with ADT (Patel et al, 2020). Randomized clinical trials that aim to evaluate the role of androgen-targeted therapies for the treatment of COVID-19 are currently ongoing.…”

Section: Sars-cov-2 Structure and Internalizationmentioning

confidence: 99%

COVID-19 and Cancer: Current Challenges and Perspectives

et al. 2020

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Patients with cancer have been disproportionately affected by the COVID-19 pandemic. This effect has included the adverse outcomes in patients with cancer who develop COVID-19, the impact of the COVID-19 pandemic on the delivery of cancer care, and the severe disruption to cancer research. However, patients with cancer are a heterogeneous population, and recent studies have now documented factors that allow risk stratification of patients with cancer in order to optimize care. In this review, we highlight data at the intersection of COVID-19 and cancer, including the biological interplay between the two diseases and practical recommendations for the treatment of patients with cancer during the pandemic. We additionally discuss the potential long-lasting impact of the pandemic on cancer care due to its deleterious effect on cancer research, as well as biological insights from the cancer research community that could help develop novel therapies for all patients with COVID-19.

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Section: Sars-cov-2 Structure and Internalizationmentioning

confidence: 99%

COVID-19 and Cancer: Current Challenges and Perspectives

et al. 2020

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“…No significant differences were observed between prostate cancer patients and those affected by other types of cancers. 39 In support of these findings, Patel et al 62 identified 58 patients with prostate cancer, 22 on ADT and 36 not on ADT. The cohorts were reasonably matched apart from the ADT group and having higher incidence of metastatic disease (64% vs. 0%) and higher rates of pulmonary disease (27% vs. 6%).…”

Section: Lessons From Recent Covid-19 Studies?mentioning

confidence: 87%

COVID-19, Type 2 Diabetes, and Hypogonadism: Lessons for Acute Management and Long-Term Prevention

Hackett

Kirby

2020

Androgens: Clinical Research and Therapeutics

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Despite similar infection rates due to COVID-19 (SARS CoV-2) between men and women, male patients have twice the mortality rate across older age groups compared with women. Studies from China, Germany, and Italy suggest that there is a severe primary hypogonadism associated with acute infection and that the more severe the drop in testosterone, the higher the mortality. The co-morbidities associated with increased mortality, namely age, obesity, type 2 diabetes, chronic obstructive pulmonary disease, and chronic kidney disease are all associated with lower rates of testosterone in the general population. Longitudinal studies of testosterone therapy in these conditions have shown reduced all cause mortality. These findings suggest that screening for low testosterone and treating low levels might reduce all-cause mortality including COVID-19. Paradoxically, some observational studies in prostate cancer patients have reported lower mortality rates in those receiving androgen deprivation therapy (ADT). This has led to studies of ADT to reduce mortality associated with COVID-19 infection and suggestions that testosterone replacement therapy (TRT) should be stopped. This seems ill advised as recent publications suggest that TRT can reverse progression to type 2 diabetes and even lead to complete regression, as well as reducing all-cause mortality. In contrast, ADT has been repeatedly shown to have adverse cardio-metabolic effects with increased rates of depression, suicide and reduced quality of life. We also suggest a potentially important role for daily PDE5 inhibitors based on their established beneficial effect on endothelial dysfunction, pulmonary hypertension, insulin resistance, inflammation and cellular apoptosis.

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“…Importantly, the opportunity for SARS-CoV-2 infection of being androgen-mediated [ 296 ] via the androgen receptor-TMPRSS2 link, where the transcription of the TMPRSS2 is controlled by the androgen receptor activity [ 297 ], can represent a mechanistic explanation for the known sex-related differences in the COVID-19 vulnerability and lethality, with males typically being more susceptible to the infection [ 298 , 299 , 300 ]. This also suggests that androgen deprivation therapy, leading to the reduction of the TMPRSS2 expression, thereby limiting SARS-CoV-2 cellular entry, could potentially protect against severe complications from COVID-19 [ 301 , 302 , 303 ].…”

Section: Human (Host) Factorsmentioning

confidence: 99%

Why COVID-19 Transmission Is More Efficient and Aggressive Than Viral Transmission in Previous Coronavirus Epidemics?

2020

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causing a pandemic of coronavirus disease 2019 (COVID-19). The worldwide transmission of COVID-19 from human to human is spreading like wildfire, affecting almost every country in the world. In the past 100 years, the globe did not face a microbial pandemic similar in scale to COVID-19. Taken together, both previous outbreaks of other members of the coronavirus family (severe acute respiratory syndrome (SARS-CoV) and middle east respiratory syndrome (MERS-CoV)) did not produce even 1% of the global harm already inflicted by COVID-19. There are also four other CoVs capable of infecting humans (HCoVs), which circulate continuously in the human population, but their phenotypes are generally mild, and these HCoVs received relatively little attention. These dramatic differences between infection with HCoVs, SARS-CoV, MERS-CoV, and SARS-CoV-2 raise many questions, such as: Why is COVID-19 transmitted so quickly? Is it due to some specific features of the viral structure? Are there some specific human (host) factors? Are there some environmental factors? The aim of this review is to collect and concisely summarize the possible and logical answers to these questions.

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Does androgen deprivation therapy protect against severe complications from COVID-19?

Cited by 72 publications

References 5 publications

COVID-19 and Cancer: Current Challenges and Perspectives

COVID-19 and Cancer: Current Challenges and Perspectives

COVID-19, Type 2 Diabetes, and Hypogonadism: Lessons for Acute Management and Long-Term Prevention

Why COVID-19 Transmission Is More Efficient and Aggressive Than Viral Transmission in Previous Coronavirus Epidemics?

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