Osteoporosis care during the COVID-19 pandemic

ABSTRACT

COVID-19 is an emerging infectious disease that has specific characteristics that interfere with the care of patients with osteoporosis. This article discusses the interfaces between osteological issues and COVID-19. A prevalent fracture very modestly increases the risk of death from COVID-19 but in hospitalized patients, the prevalence of vertebral fracture can be considered another aspect of polymorbidity increasing the likelihood of an adverse course of infection. Vitamin D deficiency correlates with worse outcomes in COVID-19, and sufficient vitamin D saturation is very likely protective in relation to COVID-19. Containment measures at the peak of the pandemic may result in muscle loss and increased risk of falls in the elderly. Densitometry and majority of laboratory tests can be easily delayed in patients with osteoporosis. This also applies to parenteral administration of bisphosphonates, whereas continuation of oral bisphosphonate therapy can be ensured by electronic prescription. Teriparatide should not be discontinued for more than 2–3 months, and the interval between denosumab administrations should not exceed 7 months.