Prognostic Role of Prostate-Specific Antigen (PSA) in male patients hospitalized for COVID-19

TL;DR

Higher prostate-specific antigen (PSA) levels in men with COVID-19 are linked to increased risk of death and severe illness.

Contribution

This study identifies PSA as a potential biomarker for predicting mortality and morbidity in male COVID-19 patients.

Findings

Patients with high PSA levels had higher mortality (38.0% vs. 26.1%) and intubation rates (50.5% vs. 36.8%).

High PSA patients had longer hospital stays and higher SOFA and APACHE II scores.

PSA elevation is associated with increased severity and risk in hospitalized male COVID-19 patients.

Abstract

In this study, we aimed to examine the relationship between Prostate-Specific Antigen (PSA) level and mortality and morbidity of COVID-19 disease.

Demographic characteristics, PSA levels, comorbidities and clinical outcomes of male patients hospitalized at Bozyaka Training and Research Hospital between May 2020 to October 2021 due to COVID-19 and who had PSA measurements within the last one year were retrospectively analyzed. Exclusions included recent urologic intervention androgen deprivation therapy and five alpha reductase inhibitors. Mortality and morbidity rates were compared between patients with high PSA levels and those with normal PSA levels according to age. Age-specific PSA values followed the Oesterling guideline. Statistical analysis used T-test, Mann-Whitney U and chi-square tests, with significant set at p < 0.05

Of 664 patients, 42.2% had normal PSA levels, 57.8% had high PSA levels. Overall mortality was 32.0%. Mortality was higher in high PSA patients than normal PSA patients. (38.0% vs. 26.1%, p=0.0012). Intubation rates were higher in the high PSA group than normal PSA group (50.5% vs. 36.8%, p=0.0004). Hospital stays were longer and SOFA and APACHE II scores were higher in high PSA patients.

PSA elevation is linked to increased mortality and morbidity in COVID-19 patients. PSA level may serve as a biomarker for risk assessment in COVID-19 patients.