Prostate cancer and COVID-19 outcomes: Results from the Cleveland Clinic registry of COVID-19 and cancer patients

ABSTRACT

Background: The impact of disease characteristics and androgen deprivation therapy (ADT) or other treatments for prostate cancer (PC) on severity of infection with Covid-19 has not been elucidated. We report results from our PC patients (pts) with Covid-19 in our registry of Covid-19 treated cancer patients at the Cleveland Clinic Foundation. Methods: We performed a retrospective analysis of PC pts who tested positive for Covid-19 between 3/16/2020 and 5/21/2020 at the Cleveland Clinic. Additional information including prostate specific antigen (PSA), Gleason score, disease extent, and current treatment were also obtained. Severe Covid-19 infection was defined as any pt requiring hospitalization, ICU care, and/or death. PSA values from prior to Covid-19 infection or first available after Covid-19 infected were collected. Analysis was carried out with Fisher's exact test and Wilcoxon rank sum test, as applicable, and overall survival (OS) by log rank test. Results: A total of 54 pts with prostate cancer that tested positive for Covid-19 were identified, of which 4 were receiving active treatment (2 with metastatic disease and 2 with localized disease). Of the 2 pts with metastatic disease, 1 was on docetaxel with ADT and other on abiraterone/prednisone with ADT. Of the 2 pts with localized disease, 1 was on ADT and bicalutamide and other on ADT alone. A total of 40 patients had severe Covid-19 disease. There was no correlation with ADT and Covid-19 disease severity (p=0.67). There were 22 pts with Gleason 6, 20 pts with Gleason 7, 6 pts with Gleason 8, 4 pts with Gleason 9, 1 pt with Gleason 10, and 1 pt with Gleason unknown PC. There was no correlation between absolute (p=0.21) or divided (p=0.65) Gleason score with disease severity. There were 4 pts with metastatic disease and 46 with localized disease and no correlation was seen with extent of disease and Covid-19 severity (p>0.99). Fifty pts had PSA data available, and there was no correlation of PSA with Covid-19 disease severity (p=0.28). The mortality from Covid-19 was 26% (14 out of 54 pts) in our cohort. Out of the 14 pts who died, 2 were on active treatment that included ADT. There was no association between Gleason score (p=0.2649), extent of disease (p=0.9642), or treatment (p=0.5998) and OS. Conclusions: In our registry of Covid-19 treated cancer patients, we did not see any correlation between PC disease-risk factors and treatment with Covid-19 severity. While the results are limited by small patient population, they provide valuable information that PC treatment did not affect severity of Covid-19.