Remote management of osteoporosis in the first wave of the COVID-19 pandemic
Tóm tắt
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. 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. 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. 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. 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.
Tài liệu tham khảo
Pedersen SF, Ho Y-C (2020) SARS-CoV-2: a storm is raging. J Clin Invest 130:2202–2205. https://doi.org/10.1172/JCI137647
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-y
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)30566-3
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/s11657-013-0136-1
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
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
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.2020.10.003
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/s00198-020-05811-4
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/s41999-020-00447-3
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.2020.12.028
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-20-0377
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–G48
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–G39
Fleseriu M, Dekkers OM, Karavitaki N (2020) Endocrinology in the time of COVID-19: management of pituitary tumours. Eur J Endocrinol 183:G17–G23
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–G15
Gittoes NJ, Criseno S, Appelman-Dijkstra NM et al (2020) Management of calcium metabolic disorders and osteoporosis. Eur J Endocrinol 183:G57–G65
Regione Marche (2020) Report COVID-19 Regione Marche. https://www.regione.marche.it/Regione-Utile/Salute/Coronavirus/Report-contagiati-per-Comune
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-x
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/s00223-018-0401-9
Ralston SH, Schett G (2018) Osteoimmunology. Calcif Tissue Int 102:501–502. https://doi.org/10.1007/s00223-018-0421-5
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/medicina56030138
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-z
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/s12020-020-02500-4
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
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.2017.07.007
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-2014-206680
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/s11154-016-9405-9
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/jbm4.10417
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.2017.07.010
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-20-0665
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.15495
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.2020.04.050
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/s40520-020-01619-8
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.2020.111106
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
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/s00394-020-02411-0
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-2020-001454
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
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/nu13010219