ABSTRACT
OBJECTIVE: The protective effect of androgen deprivation therapy (ADT) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel hypothesis. ADT may protect patients with prostate cancer through the inhibition of androgen receptor-dependent transmembrane serine protease type 2. We analyzed the role of ADT on SARS-CoV-2 infection risk and disease severity. MATERIAL AND METHODS: Between August 2020 and June 2021, patients with prostate cancer were included in our study. Patients were divided into two groups as men receiving ADT or not. Patients' characteristics such as prostate cancer grade and stage, comorbidities, SARS-CoV-2 infection status, and infection severity were assessed. SARS-CoV-2-infected close relatives and patients' compliance with the precautions against SARSCoV- 2 were also analyzed. RESULTS: A total of 365 patients, 138 (37.8%) with ADT and 227 (62.2%) without ADT, were included in our analysis. Patients with ADT were older (71.8 vs 66.9 years, P » .001) and had a higher rate of chronic obstructive pulmonary disease (11.6% vs 5.7%, P » .044). Patients receiving ADT were more often locally advanced and metastatic (80.4% vs 32.6%, P » .001). SARS-CoV-2 infection rates were statistically similar between patients who received and did not receive ADT (9.4% vs 13.2%, P » .275, respectively). There was no significant difference between two groups in terms of hospitalization rates (2.9% vs 0.9%, P » .205). In multivariate analysis, the presence of SARS-CoV-2-infected close relatives and precautions score were only independent predictors for both risk of SARS-CoV-2 infection and infection severity. CONCLUSION: We could not find any effect of ADT on risk and severity of SARS-CoV-2 infection. SARSCoV- 2 infection and hospitalization rates were similar between patients with and without ADT.
ABSTRACT
Background/aim: The aim of this paper was to determine the general tendencies of urology patients and effect of COVID-19 pandemic on daily urological practice at tertiary centers located in the most affected area in Turkey. Materials and methods: We retrospectively analyzed the data of 39,677 patients (group 1) that applied to 6 different large-volume tertiary centers in Istanbul for outpatient consultation, surgery, or other procedures in the 3-month period between March 16 and June 14, 2020. The distribution of the number of patients who applied to subspecialty sections of urology outpatient clinics and inpatient services were recorded by weeks. That data was compared to data obtained from 145,247 patients that applied to the same centers in the same period of the previous year (group 2). The reflection of worldwide and Turkish COVID-19 case distribution on the daily urological practice was analyzed. Results: There was a decrease in the number of patients in all subspecialty sections the in group 1 compared to group 2; however, there was a significant proportional increase in urooncology and general urology admissions. A decrease of approximately 75% was observed in the total number of surgeries (p < 0.001). We detected a negative correlation between the numbers of admission to all outpatient clinics and COVID-19 cases or deaths in Turkey (p < 0.05). The same negative correlation was present for all surgical procedures and consultations (p < 0.05). The multivariate linear regression analysis revealed that the number of cases in Turkey, and the number of deaths worldwide affect the number of outpatient clinic admissions (R2 = 0.38, p = 0.028) and urological surgery (R2 = 0.33, p = 0.020) in Turkey negatively. Conclusion: This novel pandemic has implications even for urology practice. Urological surgical procedures were more affected by COVID-19-related deaths in Turkey and worldwide. Outpatient admissions and urological surgeries decreased significantly by increasing COVID-19 case numbers in Turkey and worldwide deaths.