RESUMO
There are gender differences in susceptibility and vulnerability to the Coronavirus disease 2019 (COVID-19). The S protein of coronaviruses facilitates viral entry into target cells and employs the host cellular serine protease TMPRSS2 for S protein priming. The TMPRSS2 gene expression is responsive to androgen stimulation and it could partially explain gender differences. We tested the hypothesis that men who received 5-Alpha reductase inhibitors (5ARIs) or androgen deprivation therapy (ADT) for prostate cancer could have a different susceptibility to COVID-19. We carried out an observational study on patients who were referred to our COVID-19 regional centre in Lombardy from 1 to 31st March 2020. Data from 421 patients, 137 women (32.54%) and 284 men (67.44%) with laboratory-confirmed COVID-19, were included in this report. Overall 84 patients died: 28 women (33.33%) and 56 men (66.67%). Among men, 12 patients (4.22%) reported assuming 5ARI treatment, and 6 were under ADT. Over 12 patients under 5ARIs, 3 (25%) died; 2 deaths (33%) were reported in patients under ADT. Our findings showed that only 4.22% of the overall population received 5ARI anti-androgen therapy, a percentage, which revealed to be significantly lower (P<0.0001) than what observed in Italian men aged more than 40 years (14.97%).
