Key clinical point: Although patients with cancer have an increased risk of SARS-CoV-2 infection, those with prostate cancer receiving androgen-deprivation therapies (ADT) may be partially protected from infection.

Major finding: Patients with prostate cancer receiving ADT had a significantly lower risk for SARS-CoV-2 infection compared with patients who did not receive ADT (odds ratio, 4.05; 95% confidence interval, 1.55-10.59).

Study details: The study analyzed data for 9,280 patients (4,532 males) with laboratory-confirmed SARS-CoV-2 infection from 68 hospitals in Italy, of which 118 had prostate cancer.

Disclosures: The study was supported by grants from the European Research Council, Swiss Cancer League, Swiss National Science Foundation, Prostate Cancer Foundation, and the Italian Association for Cancer Research. The authors declared no conflicts of interest.

Commentary

"The potentially severe and diverse clinical presentations of COVID-19 have resulted in an exceptionally large number of observational studies designed to investigate a wide variety of hypotheses. Such studies have identified that cancer patients have a higher likelihood of contracting COVID-19 and developing more serious disease. TMPRSS2 is a protease involved in many cellular processes in normal cells and cancer cells and is a major component in the process of SARS-CoV-2 cell entry. Androgen deprivation therapy (ADT) downregulates TMPRSS2, so it was hypothesized that hormonal therapy may be beneficial to patients with COVID-19. Montopoli et al identified 4532 males with COVID-19, of which 2.6% had prostate cancer. Of note, patients receiving ADT had a clinically meaningful and statistically significantly lower risk of COVID-19 infection than those not receiving ADT. This is an interesting hypothesis that warrants further study in this widespread disease."

Mark Klein, MD