Protective potential of 5-alpha-reductase inhibitors on Covid-19 incidence and severity: results from retrospective cohort study FOUNDER (features of a new coronavirus infection course and options therapy depending on the androgenic status)


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Abstract

Materials and methods. In our study, electronic medical records of 1678 patients with prostatic hyperplasia were analyzed. 1490 men aged 71 (64-76) years were selected for final analysis. Vaccination against COVID-19 was carried out in 730 patients (49%). Treatment with 5-ARI inhibitors was carried out in 269 (18.1%) patients. Results. Among 1490 included patients 790 (53%) had COVID-19 while 360 (45.7%) of them required hospitalization. During the multivariate analysis, only two factors were associated with the risk of COVID-19 in the cohort studied: vaccination (odds ratio (OR) =0.095; 95% confidence interval (CI) 0.074-0.122), i.e. a 90.5% chance reduction, p<0.001) and the fact of taking 5-ARI (OR=0.235; 95%CI=0.165-0.335; p<0.001), i.e. a 76.5% chance reduction. The duration of 5-ARI therapy was not associated with the incidence of new coronavirus infection. The severe course of COVID-19 which required hospitalization was positively associated with age (p=0.025) and the presence of coronary artery disease (p=0.004); and negatively associated with the frequency of vaccination (p<0.001) and treatment of 5-ARI (3.1% vs. 11.6%, p<0.001). In a multivariate analysis of outpatient patients with prostatic hyperplasia who had COVID-19, 5-ARI intake (OR=0.240; 95% CI 0.122-0.473; p<0.001) and vaccination (OR = 0.570; 95% CI 0.401-0.808; p=0.002). The factors associated with increased chances of hospitalization due to the severe course of COVID-19 were coronary heart disease (+43.8%, p=0.019) and older age (+1.7% by one year, p=0.046). Conclusion. Taking 5-ARI, along with vaccination in patients with prostatic hyperplasia is a protective factor for morbidity and the severity of COVID-19.

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About the authors

A. A. Kamalov

Moscow Research and Education Center of the Lomonosov Moscow State University

Email: armais.kamalov@rambler.ru
Professor, Academician RAS, Dr.Sc. (Med), Director, Medical Research and Education Center, Lomonosov Moscow State University; Head of the Department of Urology and Andrology, Faculty of Medicine, Lomonosov Moscow State University Moscow, Russia

O. Yu Nesterova

Moscow Research and Education Center of the Lomonosov Moscow State University

Email: oy.nesterova@gmail.com
resident physician at the Department of Urology and Andrology of the Faculty of Fundamental Medicine Lomonosov Moscow State University; Trainee Researcher of the Scientific Department of Urology and Andrology Moscow, Russia

Ya. A Orlova

Moscow Research and Education Center of the Lomonosov Moscow State University

Email: yaorlova@mc.msu.ru
Dr.Sc. (Med), head of Department ofAge-Associated Diseases, Medical Research and Education Center of Lomonosov Moscow State University; head of the Department of Therapy, Medical Research and Education Center ofLomonosov Moscow State University Moscow, Russia

V. Yu Mareev

Moscow Research and Education Center of the Lomonosov Moscow State University

Email: prof_mareev@ossn.ru
Professor, Dr.Sc. (Med), chief scientific researcher Moscow, Russia

Yu. V Mareev

Moscow Research and Education Center of the Lomonosov Moscow State University

Email: mareev84@gmail.com
Ph.D. (Med.), senior researcher, Department of Age-Associated Diseases, Medical Research and Education Center of Lomonosov Moscow State University; chief scientific researcher Department of Cardiology, National Medical Research Centre for Therapy and Preventive Medicine Moscow, Russia

Z. Sh Pavlova

Moscow Research and Education Center of the Lomonosov Moscow State University

Email: zukhra73@gmail.com
Ph.D. (Med.), leading researcher, Department of Age-Associated Diseases Moscow, Russia

D. A Okhobotov

Moscow Research and Education Center of the Lomonosov Moscow State University

Email: 14072003m@gmail.com
Ph.D. (Med.), Urologist, senior researcher, Scientific Department of Urology and Andrology, Medical Research and Education Center, Lomonosov Moscow State University University, Senior Lecturer, Andrology and Urology Faculty of Fundamental Medicine, Lomonosov Moscow State University Moscow, Russia

A. A Strigunov

Moscow Research and Education Center of the Lomonosov Moscow State University

Email: strigunov@yandex.ru
PhD student at the Department of Urology and Andrology of the Faculty of Fundamental Medicine Lomonosov Moscow State University; Trainee Researcher of the Scientific Department of Urology and Andrology Moscow, Russia

R. P Vasilevsky

municipal polyclinic № 134

Email: urolog-rv@yandex.ru
urologist Moscow, Russia

O. M Nesuk

Moscow Research and Education Center of the Lomonosov Moscow State University

Email: nesukom@mail.ru
Ph.D. (Med.), Assistant Chief Physician for Outpatient work Moscow, Russia

V. V Demkin

Moscow Research and Education Center of the Lomonosov Moscow State University

Email: dyemkin@mail.ru
Ph.D. (Med.), Urologist at the Department of specialized medical care Moscow, Russia

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