Data_Sheet_1_A Population-Level Analysis of the Protective Effects of Androgen Deprivation Therapy Against COVID-19 Disease Incidence and Severity.pdf
The incidence and severity of coronavirus disease 19 (COVID-19) is substantially higher in men. Sex hormones may be a potential mechanism for differences in COVID-19 outcome in men and women. We hypothesized that men treated with androgen deprivation therapy (ADT) have lower incidence and severity of COVID-19.
MethodsWe conducted an observational study of male Veterans treated in the Veterans Health Administration from February 15th to July 15th, 2020. We developed a propensity score model to predict the likelihood to undergo Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) testing. We performed multivariable logistic regression modeling adjusted with inverse probability weighting to examine the relationship between ADT and COVID-19 incidence. We conducted logistic regression analysis among COVID-19 patients to test the association between ADT and COVID-19 severity.
ResultsWe identified a large cohort of 246,087 VA male patients who had been tested for SARS-CoV-2, of whom 3,057 men were exposed to ADT, and 36,096 men with cancer without ADT. Of these, 295 ADT patients and 2,427 cancer patients not on ADT had severe COVID-19 illness. In the primary, propensity-weighted comparison of ADT patients to cancer patients not on ADT, ADT was associated with decreased likelihood of testing positive for SARS-CoV-2 (adjusted OR, 0.88 [95% CI, 0.81–0.95]; p = 0.001). Furthermore, ADT was associated with fewer severe COVID-19 outcomes (OR 0.72 [95% CI 0.53–0.96]; p = 0.03).
ConclusionADT is associated with reduced incidence and severity of COVID-19 amongst male Veterans. Testosterone and androgen receptor signaling may confer increased risk for SARS-CoV-2 infection and contribute to severe COVID-19 pathophysiology in men.
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References
- https://doi.org//10.1001/jama.2020.6775
- https://doi.org//10.3389/fpubh.2020.00418
- https://doi.org//10.1016/j.orcp.2020.07.002
- https://doi.org//10.1016/S0140-6736%2820%2930526-2
- https://doi.org//10.1186/s13293-020-00304-9
- https://doi.org//10.3389/fimmu.2018.00794
- https://doi.org//10.1016/j.cellimm.2015.02.004
- https://doi.org//10.1001/jama.2020.12839
- https://doi.org//10.1056/NEJMsr2005760
- https://doi.org//10.1128/JVI.02202-13
- https://doi.org//10.1016/j.cell.2020.02.052
- https://doi.org//10.1158/2159-8290.CD-20-0451
- https://doi.org//10.1016/j.bbrc.2020.05.179
- https://doi.org//10.1136/jclinpath-2020-206987
- https://doi.org//10.1093/infdis/jiv246
- https://doi.org//10.1016/j.annonc.2020.04.479
- https://doi.org//10.1097/JU.0000000000001338
- https://doi.org//10.1016/j.annonc.2020.06.023
- https://doi.org//10.1016/j.annonc.2020.06.015
- https://doi.org//10.1016/j.annonc.2021.01.067
- https://doi.org//10.1097/01.mlr.0000182534.19832.83
- https://doi.org//10.1038/s41467-020-19478-2
- https://doi.org//10.1177/0962280210395740
- https://doi.org//10.1136/bmj.l5657
- https://doi.org//10.1186/1471-2288-8-48
- https://doi.org//10.4049/jimmunol.1801403
- https://doi.org//10.1038/s41586-020-2588-y
- https://doi.org//10.3389/fimmu.2017.00029
- https://doi.org//10.1073/pnas.1402468111
- https://doi.org//10.1101/2021.05.18.21257396
- https://doi.org//10.1002/emmm.201000080
- https://doi.org//10.1152/physrev.00038.2017
- https://doi.org//10.1161/HYPERTENSIONAHA.120.15595
- https://doi.org//10.1152/ajpregu.00864.2007
- https://doi.org//10.1152/ajpheart.00755.2020
- https://doi.org//10.1016/j.mayocp.2021.08.009
- https://doi.org//10.1210/en.2003-0015
- https://doi.org//10.1210/endocr/bqab114
- https://doi.org//10.1177/20420188211010105
- https://doi.org//10.1001/jamanetworkopen.2021.11398
- https://doi.org//10.1016/j.ebiom.2021.103246
- https://doi.org//10.1111/jdv.16956
- https://doi.org//10.1101/2022.02.16.21265846
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