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Volume 25, Issue 3 (May 2023) 25, 366–374; 10.4103/aja202246

Impacts of androgen deprivation therapy on the risks and outcomes of SARS-CoV-2 infection in patients with prostate cancer

Yuan-Bin Huang1,2, Wei-Lin Li1,3, Man Sun1,2, Xu Duan3, Yu-Tong Wang3, Lu-Xin Zhang2, Zi-Han Xin3, Zhi-Fei Yun4, Bo Fan1, Xian-Cheng Li1

1 Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian 116000, China
2 Second Clinical College, Dalian Medical University, Dalian 116000, China
3 First Clinical College, Dalian Medical University, Dalian 116000, China
4 Department of Nephrology, Sino-Japanese Friendship Hospital of Jilin University, Changchun 130031, China

Correspondence: Dr. XC Li (xiancheng_li@sina.cn) or Dr. B Fan (fanbo@dmu.edu.cn)



Studies have investigated the effects of androgen deprivation therapy (ADT) use on the incidence and clinical outcomes of coronavirus disease 2019 (COVID-19); however, the results have been inconsistent. We searched the PubMed, Medline, Cochrane, Scopus, and Web of Science databases from inception to March 2022; 13 studies covering 84 003 prostate cancer (PCa) patients with or without ADT met the eligibility criteria and were included in the meta-analysis. We calculated the pooled risk ratios (RRs) with 95% confidence intervals (CIs) to explore the association between ADT use and the infection risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and severity of COVID-19. After synthesizing the evidence, the pooled RR in the SARS-CoV-2 positive group was equal to 1.17, and the SARS-CoV-2 positive risk in PCa patients using ADT was not significantly different from that in those not using ADT (P = 0.544). Moreover, no significant results concerning the beneficial effect of ADT on the rate of intensive care unit admission (RR = 1.04, P = 0.872) or death risk (RR = 1.23, P = 0.53) were found. However, PCa patients with a history of ADT use had a markedly higher COVID-19 hospitalization rate (RR = 1.31, P = 0.015) than those with no history of ADT use. These findings indicate that ADT use by PCa patients is associated with a high risk of hospitalization during infection with SARS-CoV-2. A large number of high quality studies are needed to confirm these results.

Keywords: androgen deprivation therapy; coronavirus disease 2019; meta-analysis; prostate cancer; severe acute respiratory syndrome coronavirus 2

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Asian Journal of Andrology CN 31-1795/R ISSN 1008-682X  Copyright © 2023  Shanghai Materia Medica, Chinese Academy of Sciences.  All rights reserved.