J Korean Med Sci.  2022 Aug;37(31):e237. 10.3346/jkms.2022.37.e237.

Relationship Between Androgen Deprivation Therapy for Prostate Cancer and Risk of SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis

• Kim DK
• Park JJ
• Yang WJ
• Doo SW
• Kim JH

• KMID: 2532317
• DOI: http://doi.org/10.3346/jkms.2022.37.e237

Abstract

Background
Several cohort studies have explored the relationship between androgen deprivation therapy (ADT) and the severity of coronavirus disease 2019 (COVID-19). This study aimed to characterize the relationship between ADT and the severity of COVID-19 in patients with prostate cancer.
Methods
A systematic search was conducted using PubMed, Embase, and Cochrane Library databases from the inception of each database until February 31, 2020. Patients with prostate cancer who were treated with ADT were assigned to treatment group while those patients who were not treated with ADT were assigned to the control group. Outcomes were severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) positivity, hospitalization, intensive care unit (ICU) admission, and death. The risk of bias was evaluated using ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions) tool.
Results
Three studies with qualitative synthesis were included. Finally, two studies with quantitative synthesis having a total of 44,213 patients were included for the present systematic review. There was no significant difference in SARS-CoV-2 positive rate (odds ratio [OR], 0.52; 95% confidence intervals [Cis], 0.13–2.09; P = 0.362), hospitalization (OR, 0.52; 95% CIs, 0.07–3.69; P = 0.514), ICU admission (OR, 0.93; 95% CIs, 0.39–2.23, P = 0.881), or death (OR, 0.88; 95% CIs, 0.06–12.06; P = 0.934) between ADT and non-ADT groups.
Conclusion
Qualitative and quantitative analyses of previous studies revealed no significant effect of ADT on COVID-19. However, more studies with higher quality that explore biochemical and immunological factors involved are needed to confirm this finding in the future.

Keyword

Prostate Cancer; Androgen Deprivation Therapy; COVID-19; SARS Virus

Figure

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  Fig. 1 Preferred reporting items for systematic reviews and meta-analysis.

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  Fig. 2 Forest plots of (A) SARS-CoV-2 positivity, (B) hospitalization, (C) ICU admission, (D) death.ADT = androgen deprivation therapy, SARS-CoV-2 = severe acute respiratory syndrome-coronavirus-2, ICU = intensive care unit.

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  Fig. 3 Risk of bias graph.

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  Fig. 4 Risk of bias assessment. Green plus: low risk of bias; Yellow question: unclear risk of bias; Red minus: high risk of bias.

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  Fig. 5 Funnel plots for publication bias: (A) severe acute respiratory syndrome-coronavirus-2 positivity, (B) hospitalization, (C) ICU admission, and (D) death.SE = standard error, OR = odds ratio.

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