Androgen Deprivation Therapy May Be a More Effective COVID-19 Prophylactic Than Therapeutic Strategy

The document discusses the potential role of androgen deprivation therapy (ADT) as a prophylactic rather than a therapeutic strategy for COVID-19, based on the hypothesis that androgens may influence the expression of TMPRSS2, a protein that facilitates SARS-CoV-2 entry into cells. A study by Montopoli et al. suggested that men undergoing ADT for prostate cancer had a lower incidence of COVID-19, but ADT did not reduce disease severity. The document highlights that TMPRSS2 is not highly expressed in the lungs and is not controlled by androgens in this tissue, challenging the idea that ADT could mitigate SARS-CoV-2 lung infection. Furthermore, no differences in TMPRSS2 expression were found between male and female lungs, and ADT did not affect TMPRSS2 expression in mouse lungs. The document concludes that while androgens may contribute to the higher incidence of COVID-19 in men, it is unlikely through TMPRSS2 modulation. The study by Montopoli et al. involved a small cohort of 4 patients undergoing ADT, which limits the conclusions that can be drawn regarding mortality rates. The document suggests that androgens may still be a determinant of SARS-CoV-2 susceptibility, possibly through their immunosuppressive properties, but more research is needed to clarify their role.