Outcomes of prostate cancer patients hospitalized with viral respiratory illnesses: A national population-based study.

Abstract

e17008 Background: Prostate cancer patients are exposed to hormonal anti-androgenic therapy as a part of their treatment regimen. Previous studies compared outcomes between different hormonal agents, but the specific mortality rate and other outcomes of patients admitted to the hospital with acute hypoxic respiratory failure (AHRF) secondary to COVID-19, RSV, and Influenza is not known. This study seeks to address this knowledge gap by investigating these outcomes. Methods: The National Inpatient Sample Database (2016–2021 for RSV and Influenza, and 2020-2021 for COVID-19) of the HCUP was used. We applied discharge weight provided in the database to generate the national estimates. Pearson Chi-square test for categorical variables and Student’s t-tests/one-way ANOVA for continuous variables were applied to compare the baseline demographics and hospital characteristics between the groups. Mortality was the primary outcome while length of stay, total hospitalization charges, the use of mechanical ventilation and ECMO constituted the secondary outcomes. Multivariate linear and logistic regression models were used to adjust for confounders such as age, tobacco use, hypertension, COPD, Ischemic heart disease, and prior CVA. Results: Among 931,289 hospitalizations for AHRF secondary to COVID-19, RSV and Influenza, 4,1119 patients had prostate cancer. After adjusting for confounders, there were higher odds of in-hospital mortality in prostate Ca patients hospitalized with Influenza (aOR: 1.52; CI 1.18-1.96; p-value < 0.001) and longer LOS (6.1 vs. 5.7 days, p 0.0026). There was a significant decrease in the use of mechanical ventilation in patients hospitalized for COVID-19 (aOR: 0.83; CI 0.73-0.5; p-value < 0.008). There were no significant differences in outcomes for patients hospitalized for RSV. Conclusions: Prostate cancer patients have worse outcomes when they are hospitalized for influenza but also have lower odds of mechanical ventilation when they are hospitalized with COVID. Further focused studies on the use of hormonal therapy in the management are needed to find attributable causes for these differences in vulnerability. And more efforts should be made in ensuring proper vaccination and early infection recognition in this patient population. Prostate Ca vs No-Prostate Ca in Influenza (aOR, P-value, CI) Prostate Ca vs No-Prostate Ca in RSV (aOR, P-value, CI) Prostate Ca vs No-Prostate Ca in COVID-19 (aOR, P-value, CI) In-Hospital Mortality 1.52, < 0.001*, 1.18 - 1.96 1.58, 0.091, 0.93 - 2.7 1.09, 0.128, 0.98 - 1.21 Mechanical ventilation 0.97, 0.83, 0.76 - 1.25 0.63, 0.179, 0.32 - 12.4 0.83, 0.008*, 0.73 - 0.95 ECMO 0.32, 0.25, 0.004 - 2.27 - 0.84, 0.555, 0.46 - 1.51 Length of Stay 1.09, 0.026*, 1.01 - 1.14 1.11, 0.056, 0.99 - 1.33 1.02, 0.376, 0.98 - 1.06 Total Hospitalization Charges 1.15, 0.11, 0.97 - 1.33 1.15, 0.114, 0.88 - 1.1 1.05, 0.085, 0.99 - 1.11 *Statistically significant.