COVID-19 Pandemic and Osteoporosis in Elderly Patients

Abstract

Coronavirus disease 2019 (COVID-19), which is caused by an infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is rapidly becoming a worldwide epidemic and poses a significant threat to human life and health. SARS-CoV-2 can cause damage to organs throughout the body through ACE2 receptors. It may have direct and indirect effects on osteoclasts, and osteoblasts and lead to osteoporosis. Vitamin D (VitD) is a key hormone for bone health and has immunomodulatory actions of relevance in the context of the COVID-19 pandemic. Vitamin D deficiency has a significant positive association with both infection and the mortality rate of COVID-19. Elderly patients infected by COVID-19 were more likely to develop acute respiratory distress syndrome (ARDS), which was primarily caused by an inflammation storm. The production of proinflammatory cytokines increases with COVID-19 infection and immobilization may result in bone loss and bone resorption in seriously ill patients, especially aging patients. It is well known that glucocorticoids are beneficial in the treatment of acute respiratory distress syndrome (ARDS) because they reduce inflammation and improve the functioning of the lung and extrapulmonary organs. Glucocorticoid therapy is widely used to treat patients with COVID-19 in most parts of the world. During COVID-19 clinical treatment, glucocorticoids may accelerate bone loss in elderly people, making them more susceptible to the development of osteoporosis. Therefore, it is worthwhile to draw the attention of clinicians and researchers to the linkages and interactions between COVID-19, glucocorticoids, and osteoporosis (especially in elderly patients).

Aging During the Pandemic: Untangling the Complexities of COVID-19 and Geriatric Care

“…In addition, the pandemic has limited the access to healthcare services, such as routine check-ups and diagnostic tests, thereby further exacerbating the issue. The author also emphasizes the connections among COVID-19, glucocorticoids, and osteoporosis in elderly patients, including stress, altered sleeping patterns, and poor nutrition [7]. Furthermore, a systematic review of the effect of COVID-19-related lockdowns on diet and physical activity in older adults reveals that lockdowns causes a decline in physical activity and deterioration of dietary habits in this population [8].…”

“…SARS-CoV-2 infection increases the risk of bone loss and resorption in the elderly. Tang opines that the pandemic's influence on lifestyle, healthcare, and treatment accessibility has raised the incidence of osteoporosis in older adults [7]. According to the author, lockdown measures, social isolation, and decreased physical activity have all contributed to the deterioration of bone health in the elderly [7].…”

“…Tang opines that the pandemic's influence on lifestyle, healthcare, and treatment accessibility has raised the incidence of osteoporosis in older adults [7]. According to the author, lockdown measures, social isolation, and decreased physical activity have all contributed to the deterioration of bone health in the elderly [7]. In addition, the pandemic has limited the access to healthcare services, such as routine check-ups and diagnostic tests, thereby further exacerbating the issue.…”

Absorption and transport properties of a codfish-derived peptide and its protective effect on bone loss in ovariectomized mice

“…However, it has been reported that glucocorticoids may accelerate bone loss in the elderly during clinical treatment, making them more susceptible to osteoporosis. 1 In addition, with the aging of the population, the prevalence of osteoporosis is increasing year by year, which has become a global medical and socio-economic issue. 2 Currently, the main medications for the treatment of osteoporosis are anti-resorptive drugs and anabolic agents, including oral bisphosphonates, selective estrogen receptor modulators, intravenous bisphosphonates, teriparatide, and denosumab.…”