Top

Published in:

Open Access 01-12-2022 | SARS-CoV-2 | Original Article

Remote management of osteoporosis in the first wave of the COVID-19 pandemic

Authors: Gianmaria Salvio, Claudio Gianfelice, Francesca Firmani, Stefano Lunetti, Rossella Ferroni, Giancarlo Balercia, Gilberta Giacchetti

Published in: Archives of Osteoporosis | Issue 1/2022

Abstract

Summary

We conducted a survey during the first pandemic wave of coronavirus disease 2019 (COVID-19) on a large group of osteoporotic patients to evaluate the general conditions of osteoporotic patients and the impact of the pandemic on the management of osteoporosis, finding high compliance to treatments and low COVID-19 lethality.

Introduction

During the first pandemic wave of coronavirus disease 2019 (COVID-19), 209,254 cases were diagnosed in Italy; fatalities were 26,892 and were overwhelmingly older patients. The high prevalence of osteoporosis in this age group suggests a potential relationship between SARS-CoV-2 infection and bone metabolism.

Methods

In a telephone survey conducted from April to May 2020, patients from the Osteoporosis Center, Clinic of Endocrinology and Metabolic Diseases of Umberto I Hospital (Ancona, Italy), were interviewed to evaluate the general clinical conditions of osteoporotic patients, compliance with osteoporosis medications, COVID-19 prevalence, hospitalization rate, COVID-19 mortality, and lethality.

Results

Among the 892 patients interviewed, 77.9% were taking osteoporosis treatment and 94.6% vitamin D supplementation as prescribed at the last visit. COVID-19-like symptoms were reported by 5.1%, whereas confirmed cases were 1.2%. A total number of 33 patients had been in hospital and the hospitalization rate of those who had not discontinued vitamin D supplementation was less than 4%. There were eight deaths, two with a concomitant COVID-19 diagnosis. The prevalence of severe osteoporosis was 50% in total COVID-19 patients and 87.5% in deceased COVID-19 patients. The overall COVID-19 mortality was 0.2%; lethality was 20%, lower than the national rate of the same age group.

Conclusions

This large group of osteoporotic patients showed high compliance and lower COVID-19 lethality compared to patients of the same age. Novel approaches such as telemedicine can provide critical support for the remote follow-up of patients with chronic diseases also in the setting of routine care.

Pedersen SF, Ho Y-C (2020) SARS-CoV-2: a storm is raging. J Clin Invest 130:2202–2205. https://doi.org/10.1172/JCI137647CrossRefPubMedPubMedCentral

WHO (2020) Coronavirus disease (COVID-19) pandemic. https://www.who.int/emergencies/diseases/novel-coronavirus-2019. Accessed 23 Oct 2021

Romagnani P, Gnone G, Guzzi F et al (2020) The COVID-19 infection: lessons from the Italian experience. J Public Health Policy 41:238–244. https://doi.org/10.1057/s41271-020-00229-yCrossRefPubMedPubMedCentral

ISS (2020) Report Isituto Superiore di Sanità per COVID-19

Zhou F, Yu T, Du R et al (2020) Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 395:1054–1062. https://doi.org/10.1016/S0140-6736(20)30566-3CrossRefPubMedPubMedCentral

Rossini M, Adami S, Bertoldo F, et al (2016) Linee guida per la diagnosi, la prevenzione ed il trattamento dell’osteoporosi. Reumatismo 68:1–42

Nuti R, SIE, SIMFER, SIMI, SIOT, SIGG, SIMG, SIOMMMS S (2017) Commissione Intersocietaria per l’Osteoporosi. Linee Guida sulla gestione dell’Osteoporosi e delle Fratture da fragilità

Epidemiology and economic burden of osteoporosis in Italy | IRIS Verona. https://iris.univr.it/handle/11562/626966#.XpGYIsgzaUk. Accessed 11 Apr 2020

Hernlund E, Svedbom A, Ivergård M et al (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden: a report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos. https://doi.org/10.1007/s11657-013-0136-1CrossRefPubMedPubMedCentral

10.

Salvio G, Gianfelice C, Firmani F et al (2020) Bone metabolism in SARS-CoV-2 disease: possible osteoimmunology and gender implications. Clin Rev Bone Miner Metab 1–7. https://doi.org/10.1007/s12018-020-09274-3

11.

Mi B, Chen L, Xiong Y, Xue H, Zhou W, Liu G (2020) Characteristics and early prognosis of COVID-19 infection in fracture patients. J Bone Jt Surg Am 1–9. https://doi.org/10.1080/03056244.2018.1546429

12.

Biarnés-Suñé A, Solà-Enríquez B, González Posada MÁ et al (2021) Impacto de la pandemia COVID-19 en la mortalidad del paciente anciano con fractura de cadera. Rev Esp Anestesiol Reanim 68:65–72. https://doi.org/10.1016/j.redar.2020.10.003CrossRef

13.

Pluskiewicz W, Wilk R, Adamczyk P et al (2021) The incidence of arm, forearm, and hip osteoporotic fractures during early stage of COVID-19 pandemic. Osteoporos Int. https://doi.org/10.1007/s00198-020-05811-4CrossRefPubMedPubMedCentral

14.

Ojeda-Thies C, Cuarental-García J, Ramos-Pascua LR (2021) Decreased volume of hip fractures observed during COVID-19 lockdown. Eur Geriatr Med. https://doi.org/10.1007/s41999-020-00447-3CrossRefPubMedPubMedCentral

15.

Lim MA, Mulyadi Ridia KG, Pranata R (2020) Epidemiological pattern of orthopaedic fracture during the COVID-19 pandemic: a systematic review and meta-analysis. J Clin Orthop Trauma 16:16–23. https://doi.org/10.1016/j.jcot.2020.12.028CrossRefPubMedPubMedCentral

16.

Wake DJ, Gibb FW, Kar P et al (2020) Remodelling diabetes services and emerging innovation. Eur J Endocrinol 183:G67–G77. https://doi.org/10.1530/EJE-20-0377CrossRefPubMedPubMedCentral

17.

Vrachimis A, Iakovou I, Giannoula E, Giovanella L (2020) Endocrinology in the time of COVID-19: management of thyroid nodules and cancer. Eur J Endocrinol 183:G41–G48CrossRefPubMedPubMedCentral

18.

Boelaert K, Edward Visser W, Taylor PN et al (2020) Endocrinology in the time of COVID-19: management of hyperthyroidism and hypothyroidism. Eur J Endocrinol 183:G33–G39CrossRefPubMedPubMedCentral

19.

Fleseriu M, Dekkers OM, Karavitaki N (2020) Endocrinology in the time of COVID-19: management of pituitary tumours. Eur J Endocrinol 183:G17–G23CrossRefPubMedPubMedCentral

20.

Christ-Crain M, Hoorn EJ, Sherlock M et al (2020) Endocrinology in the time of COVID-19: management of diabetes insipidus and hyponatraemia. Eur J Endocrinol 183:G9–G15CrossRefPubMedPubMedCentral

21.

Gittoes NJ, Criseno S, Appelman-Dijkstra NM et al (2020) Management of calcium metabolic disorders and osteoporosis. Eur J Endocrinol 183:G57–G65CrossRefPubMedPubMedCentral

22.

Regione Marche (2020) Report COVID-19 Regione Marche. https://www.regione.marche.it/Regione-Utile/Salute/Coronavirus/Report-contagiati-per-Comune

23.

Sinningen K, Tsourdi E, Rauner M et al (2012) Skeletal and extraskeletal actions of denosumab. Endocrine 42:52–62. https://doi.org/10.1007/s12020-012-9696-xCrossRefPubMed

24.

Dubrovsky AM, Lim MJ, Lane NE (2018) Osteoporosis in rheumatic diseases: anti-rheumatic drugs and the skeleton. Calcif Tissue Int 102:607–618. https://doi.org/10.1007/s00223-018-0401-9CrossRefPubMed

25.

Ralston SH, Schett G (2018) Osteoimmunology. Calcif Tissue Int 102:501–502. https://doi.org/10.1007/s00223-018-0421-5CrossRefPubMed

26.

De Martinis M, Ginaldi L, Sirufo MM et al (2020) Alarmins in osteoporosis, RAGE, IL-1, and IL-33 pathways: a literature review. Medicina (B Aires) 56:138. https://doi.org/10.3390/medicina56030138CrossRef

27.

Georgiev T (2020) Coronavirus disease 2019 (COVID-19) and anti-rheumatic drugs. Rheumatol Int 40:825–826. https://doi.org/10.1007/s00296-020-04570-zCrossRefPubMedPubMedCentral

28.

Formenti AM, Pedone E, di Filippo L et al (2020) Are women with osteoporosis treated with denosumab at risk of severe COVID-19? Endocrine 70:203–205. https://doi.org/10.1007/s12020-020-02500-4CrossRefPubMedPubMedCentral

29.

Blanch-Rubio J, Soldevila-Domenech N, Tio L, et al (2020) Influence of anti-osteoporosis treatments on the incidence of COVID-19 in patients with non-inflammatory rheumatic conditions. Aging (Albany NY) 12:19923–19937. https://doi.org/10.18632/aging.104117

30.

Colotta F, Jansson B, Bonelli F (2017) Modulation of inflammatory and immune responses by vitamin D. J Autoimmun 85:78–97. https://doi.org/10.1016/j.jaut.2017.07.007CrossRefPubMed

31.

Dancer RCA, Parekh D, Lax S et al (2015) Vitamin D deficiency contributes directly to the acute respiratory distress syndrome (ARDS). Thorax 70:617–624. https://doi.org/10.1136/thoraxjnl-2014-206680CrossRefPubMed

32.

Altieri B, Muscogiuri G, Barrea L et al (2017) Does vitamin D play a role in autoimmune endocrine disorders? A proof of concept. Rev Endocr Metab Disord 18:335–346. https://doi.org/10.1007/s11154-016-9405-9CrossRefPubMed

33.

Giustina A, Bouillon R, Binkley N et al (2020) Controversies in vitamin D: a statement from the third international conference. JBMR Plus 4:1–13. https://doi.org/10.1002/jbm4.10417CrossRef

34.

Vanherwegen AS, Gysemans C, Mathieu C (2017) Regulation of immune function by vitamin D and its use in diseases of immunity. Endocrinol Metab Clin North Am 46:1061–1094. https://doi.org/10.1016/j.ecl.2017.07.010CrossRefPubMed

35.

Bilezikian JP, Bikle D, Hewison M et al (2020) Mechanisms in endocrinology: vitamin D and COVID-19. Eur J Endocrinol 183:R133–R147. https://doi.org/10.1530/EJE-20-0665CrossRefPubMedPubMedCentral

36.

Merzon E, Tworowski D, Gorohovski A et al (2020) Low plasma 25(OH) vitamin D level is associated with increased risk of COVID-19 infection: an Israeli population-based study. FEBS J 287:3693–3702. https://doi.org/10.1111/febs.15495CrossRefPubMedPubMedCentral

37.

Hastie CE, Mackay DF, Ho F et al (2020) Vitamin D concentrations and COVID-19 infection in UK Biobank. Diabetes Metab Syndr Clin Res Rev 14:561–565. https://doi.org/10.1016/j.dsx.2020.04.050CrossRef

38.

Singh S, Kaur R, Singh RK (2020) Revisiting the role of vitamin D levels in the prevention of COVID-19 infection and mortality in European countries post infections peak. Aging Clin Exp Res 32:1609–1612. https://doi.org/10.1007/s40520-020-01619-8CrossRefPubMedPubMedCentral

39.

Katz J, Yue S, Xue W (2021) Increased risk for COVID-19 in patients with vitamin D deficiency. Nutrition 84:111106. https://doi.org/10.1016/j.nut.2020.111106CrossRefPubMed

40.

Baktash V, Hosack T, Patel N, et al (2020) Vitamin D status and outcomes for hospitalised older patients with COVID-19. Postgrad Med J postgradmedj-2020–138712. https://doi.org/10.1136/postgradmedj-2020-138712

41.

Abrishami A, Dalili N, Mohammadi Torbati P et al (2021) Possible association of vitamin D status with lung involvement and outcome in patients with COVID-19: a retrospective study. Eur J Nutr 60:2249–2257. https://doi.org/10.1007/s00394-020-02411-0CrossRefPubMed

42.

Cutolo M, Paolino S, Smith V (2020) Evidences for a protective role of vitamin D in COVID-19. RMD Open 6:1–7. https://doi.org/10.1136/rmdopen-2020-001454CrossRef

43.

Farid N, Rola N, Koch EAT, Nakhoul N (2021) Active vitamin D supplementation and COVID-19 infections: review. Irish J Med Sci (1971 -) 2:. https://doi.org/10.1007/s11845-020-02452-8

44.

Giannini S, Passeri G, Tripepi G et al (2021) Effectiveness of in-hospital cholecalciferol use on clinical outcomes in comorbid COVID-19 patients: a hypothesis-generating study. Nutrients 13:219. https://doi.org/10.3390/nu13010219CrossRefPubMedPubMedCentral

Title: Remote management of osteoporosis in the first wave of the COVID-19 pandemic
Authors: Gianmaria Salvio
Claudio Gianfelice
Francesca Firmani
Stefano Lunetti
Rossella Ferroni
Giancarlo Balercia
Gilberta Giacchetti
Publication date: 01-12-2022
Publisher: Springer London
Keywords: SARS-CoV-2
Osteoporosis
COVID-19
Osteoporosis
Telemedicine
Denosumab
Denosumab
Published in: Archives of Osteoporosis / Issue 1/2022
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-022-01069-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Remote management of osteoporosis in the first wave of the COVID-19 pandemic

Abstract

Summary

Introduction

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2022

Prevalent vertebral fractures among urban-dwelling Chinese postmenopausal women: a population-based, randomized-sampling, cross-sectional study

The relationship between vitamin D deficiency, body composition, and physical/cognitive functions

Development of a data-driven case-mix adjustment model for comparison of hospital performance in hip fracture care

Fragility fractures: proposal of the best practice through the fracture coordination units: the experience of Mexico

Access to care for low trauma hip fractures in South Africa

Prevalence of FRAX risk factors and the osteoporosis treatment gap among women ≥ 70 years of age in routine primary care across 8 countries in Europe