Incidence and outcomes of severe acute respiratory syndrome coronavirus 2 infection in patients with metastatic castration-resistant prostate cancer
Orazio Caffo, Donatello Gasparro, Giuseppe Di Lorenzo, Alberto Dalla Volta, Pamela Guglielmini, Paolo Zucali, Roberto Bortolus, Alessia Cavo, Giovanni Ceresoli, Rita Chiari, Giuseppe Fornarini, Lucia Fratino, Alessandro Iaculli, Marco Maruzzo, Cristina Masini, Franco Morelli, Claudia Mucciarini, Giuseppe Procopio, Roberto Sabbatini, Elena Verri, Stefania Kinspergher, Francesca Maines, Carlo Messina, Antonello Veccia, Maddalena Donini
European Journal of Cancer, doi:10.1016/j.ejca.2020.09.018
Background: Patients with cancer are at increased risk of complicated severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, but it is still unclear if the risk of mortality is influenced by cancer type or ongoing anti-cancer treatments. An interesting debate concerning the potential relationship between androgen deprivation therapy (ADT) and SARS-CoV-2 infection has recently been opened in the case of prostate cancer (PC), and the aim of this multi-centre cohort study was to investigate the incidence and outcomes of SARS-CoV-2 infection in patients with metastatic castration-resistant prostrate cancer (mCRPC). Patients and methods: We retrospectively reviewed the clinical records of patients with mCRPC who developed SARS-CoV-2 infection, and recorded their baseline clinical characteristics, their history of PC and SARS-CoV-2 infection, and their oncological status and treatment at the time of infection. The primary study end point was the death rate and the possible impact of the patients' PC-related history and treatments on mortality. Results: Thirty-four of the 1433 patients with mCRPC attending the participating centres (2.3%) developed SARS-CoV-2 infection, 22 (64.7%) of whom were hospitalised. Most of the patients were symptomatic, the most frequent symptoms being fever (70.6%), dyspnoea (61.8%), cough (52.9%) and fatigue (38.2%). After a median follow-up of 21 days (interquartile range: 13e41), 13 patients had died (38.2%), 17 recovered (50.0%) and four (11.7%) were still infected. The number of treatments previously administered for mCRPC had a significant impact on mortality (p Z 0.004). Conclusions: Our findings contribute additional data to the current debate concerning the postulated protective role of ADT, which seems to be less in patients with metastatic PC.
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