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

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 84003 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.