雄激素剥夺疗法不会影响前列腺癌男性感染 SARS-CoV-2 的风险。
Androgen Deprivation Therapy in Men with Prostate Cancer Does Not Affect Risk of Infection with SARS-CoV-2.
机构信息
Department of Urology, Glickman Urological and Kidney Institute, Cleveland, Ohio.
Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland, Ohio.
出版信息
J Urol. 2021 Feb;205(2):441-443. doi: 10.1097/JU.0000000000001338. Epub 2020 Sep 8.
PURPOSE
is a host co-receptor for cell entry of SARS-CoV-2. A prior report suggested that use of androgen deprivation therapy, which downregulates , 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.
目的
是 SARS-CoV-2 细胞进入的宿主共受体。先前的报告表明，使用下调 的雄激素剥夺疗法可能会保护前列腺癌男性免受感染。
材料和方法
这是一项对 2020 年 3 月 12 日至 6 月 10 日期间接受 SARS-CoV-2 检测的所有患者进行前瞻性登记的队列研究，随访至疾病康复或死亡。主要暴露因素是雄激素剥夺疗法的使用，观察指标是 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
研究队列包括来自总共检测的 74787 例人群中 1779 例前列腺癌男性，其中 4885 例（6.5%）SARS-CoV-2 阳性。在前列腺癌患者中，有 102 例（5.7%）SARS-CoV-2 阳性，304 例（17.1%）接受雄激素剥夺疗法。在接受雄激素剥夺疗法的患者中，阳性率为 5.6%，而未接受雄激素剥夺疗法的患者阳性率为 5.8%。接受雄激素剥夺疗法的男性年龄稍大（75.5 岁 vs 73.8 岁，p=0.009），更有可能吸烟（68.1% vs 59.3%，p=0.005），更有可能服用类固醇（43.8% vs 23.3%，p <0.001）。其他已知增加感染和疾病严重程度风险的因素分布均等（哮喘、糖尿病、高血压、冠状动脉疾病、心力衰竭和免疫抑制性疾病）。多变量分析表明，接受雄激素剥夺疗法的前列腺癌患者感染风险没有差异（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。
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