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Vertebral fractures and mortality risk in hospitalised patients during the COVID-19 pandemic emergency.
Battisti, Sofia; Napoli, Nicola; Pedone, Claudio; Lombardi, Mariangela; Leanza, Giulia; Tramontana, Flavia; Faraj, Malak; Agnoletti, Vanni; Verna, Martina; Viola, Lorenzo; Giampalma, Emanuela; Strollo, Rocky.
  • Battisti S; Radiology Department, AUSL Romagna, M. Bufalini Hospital, Cesena, Italy.
  • Napoli N; Radiology Unit, Scientific Institute of Romagna for the Study and Treatment of Tumors (IRST) IRCCS, Meldola, Italy.
  • Pedone C; Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum-Università di Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
  • Lombardi M; Department of Medicine, Unit of Endocrinology and Diabetes, Università Campus Bio-Medico di Roma, Rome, Italy.
  • Leanza G; Department of Medicine, Division of Bone and Mineral Diseases, Washington University in St. Louis, St. Louis, MO, USA.
  • Tramontana F; Department of Medicine, Unit of Geriatrics, Università Campus Bio-Medico di Roma, Rome, Italy.
  • Faraj M; Radiology Department, AUSL Romagna, M. Bufalini Hospital, Cesena, Italy.
  • Agnoletti V; Department of Medicine, Unit of Endocrinology and Diabetes, Università Campus Bio-Medico di Roma, Rome, Italy.
  • Verna M; Department of Medicine, Unit of Endocrinology and Diabetes, Università Campus Bio-Medico di Roma, Rome, Italy.
  • Viola L; Department of Medicine, Unit of Endocrinology and Diabetes, Università Campus Bio-Medico di Roma, Rome, Italy.
  • Giampalma E; Anesthesia and Intensive Care Unit, AUSL Romagna, M. Bufalini Hospital, Cesena, Italy.
  • Strollo R; Radiology Department, ASST Mantova "Carlo Poma" Hospital, Mantova, Italy.
Endocrine ; 74(3): 461-469, 2021 12.
Article in English | MEDLINE | ID: covidwho-1411789
ABSTRACT
BACKGROUND AND

OBJECTIVE:

Bone fragility has been linked to COVID-19 severity. The objective of this study was to evaluate whether a diagnosis of vertebral fracture (VF) increased mortality risk in COVID-19 patients and whether this effect was greater than in those without COVID-19.

METHODS:

We assessed VFs by computed tomography (CT) in a cohort of 501 patients consecutively admitted to the emergency department (ED) for clinical suspicion of SARS-CoV-2 infection during the first wave of pandemic emergency. Of those, 239 had a confirmed diagnosis of COVID-19.

RESULTS:

VF prevalence was similar between COVID-19 and non-COVID-19 groups (22.2 vs. 19%; p = 0.458). Death rates were similar between COVID-19 and non-COVID-19 groups at both 30 (15.8 vs. 12.2%; p = 0.234) and 120 days (21.8 vs. 17.6%; p = 0.236). The mortality risk was higher in COVID-19 patients either with one or multiple fractures compared to those without VFs, at 30 and 120 days, but statistical significance was reached only in those with multiple VFs (30-day HR 3.03, 95% CI 1.36-6.75; 120-day HR 2.91, 95% CI 1.43-5.91). In the non-COVID-19 group, the 30-day mortality risk was significantly higher in patients either with one (HR 7.46, 95% CI 3.12-17.8) or multiple fractures (HR 6.2, 95% CI 2.75-13.98) compared to those without VFs. A similar effect was observed at 120 days. After adjustment for age, sex and bone density, mortality risk remained associated with VFs in the non-COVID-19 group only.

CONCLUSIONS:

VFs were not independently associated with short-term mortality in patients with COVID-19, but they strongly increased mortality risk in those without COVID-19.
Subject(s)
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Spinal Fractures / Osteoporotic Fractures / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Endocrine Journal subject: Endocrinology Year: 2021 Document Type: Article Affiliation country: S12020-021-02872-1

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Spinal Fractures / Osteoporotic Fractures / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Endocrine Journal subject: Endocrinology Year: 2021 Document Type: Article Affiliation country: S12020-021-02872-1