The Impact of COVID-19 in Bone Metabolism: Basic and Clinical
                    Aspects

Elena Tsourdi; Lorenz C. Hofbauer; Martina Rauner

doi:10.1055/a-1825-9641

Hormone and Metabolic Research, Table of Contents

Horm Metab Res 2022; 54(08): 540-548
DOI: 10.1055/a-1825-9641

Review

The Impact of COVID-19 in Bone Metabolism: Basic and Clinical Aspects

Authors

Elena Tsourdi

¹Department of Medicine III, University Clinic Dresden Medical Center, Dresden, Germany

²Center for Healthy Aging, University Clinic Dresden Medical Center, Dresden, Germany
Lorenz C. Hofbauer

¹Department of Medicine III, University Clinic Dresden Medical Center, Dresden, Germany

²Center for Healthy Aging, University Clinic Dresden Medical Center, Dresden, Germany
Martina Rauner

¹Department of Medicine III, University Clinic Dresden Medical Center, Dresden, Germany

²Center for Healthy Aging, University Clinic Dresden Medical Center, Dresden, Germany

Abstract

The use of standard procedures for the diagnosis of osteoporosis and assessment of fracture risk significantly decreased during the COVID-19 pandemic, while the incidence of fragility fractures was mostly unaltered. Both COVID-19 per se and its treatments are associated with a negative impact on bone health. Preclinical models show that mice infected with SARS-CoV2 even without symptoms display loss of trabecular bone mass two weeks post infection, due to increased numbers of osteoclasts. Osteoporosis medications do not aggravate the clinical course of COVID-19, while preclinical data suggests possible beneficial effects of some therapies. While vitamin D deficiency is clearly associated with a worse clinical course of COVID-19, evidence of improved patient outcome with vitamin D supplementation is lacking. Osteoporosis treatment should not be generally discontinued, and recommendations for substituting therapies are available. Osteoporosis therapies do not interfere with the efficacy or side-effect profiles of COVID-19 vaccines and should not be stopped or indefinitely delayed because of vaccination.

Key words

COVID-19 - SARS-CoV2 - bone/calcium homeostasis - osteoporosis - osteopenia - fractures - vitamin D - vaccines

Full Text

References

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