Osteoporosis Management in the Era of COVID-19

Abstract

Osteoporosis is a chronic condition that reflects reduced bone strength and an associated increased risk for fracture. As a chronic condition, osteoporosis generally requires sustained medical intervention(s) to limit the risks for additional bone loss, compromise of skeletal integrity, and fracture occurrence. Further complicating this issue is the fact that the abrupt cessation of some therapies can be associated with an increased risk for harm. It is in this context that the COVID-19 pandemic has brought unprecedented disruption to the provision of health care globally, including near universal requirements for social distancing. In this Perspective, we provide evidence, where available, regarding the general care of patients with osteoporosis in the COVID-19 era and provide clinical recommendations based primarily on expert opinion when data are absent. Particular emphasis is placed on the transition from parenteral osteoporosis therapies. It is hoped that these recommendations can be used to safely guide care for patients with osteoporosis until a return to routine clinical care standards is available.

Osteoporotic Fractures in the Time of COVID-19

“…The article by Yu and colleagues (1) provides excellent guidance on treatment of osteoporosis patients during the COVID-19 pandemic. However, it ignores the very important, very preventable burden that osteoporosis has placed on hospitals in this difficult time.…”

Scientific Editing in the COVID-19 Era—Personal Vignettes from the JBMR Editors

“…We reached out to those at high risk to ensure they would keep their doctor appointments. With DXA scans put “on ice,” recommendations were based on FRAX, as described in the Perspective by Yu and colleagues . Most importantly, we ensured that prescriptions were ordered and osteoporosis therapy implemented.…”

“…I am even more impressed with how colleagues in all fields of research began asking how their skills and resources could help humanity solve the pandemic by studying the molecular structure of proteins in the novel coronavirus, designing drugs to block the virus, exploring large data sets for clues, starting clinical trials to help COVID‐19 patients, and studying the epidemiological spread of the virus and disease. The insightful Perspective in this issue of JBMR by Yu and colleagues, who include my colleagues Matthew Drake and Bart Clarke, articulates how treatment of osteoporosis patients has been and will be affected by the pandemic and is one example of how the medical community has responded to a crisis that will persist.…”

“…Our individual contributions to a great team will get us through these difficult times. In this editorial accompanying the Perspective by Yu and colleagues on guidelines for managing osteoporosis patients in the COVID‐19 era, the Deputy Editors and I decided to share experiences we have personally faced in coping with the current crisis. We hope that putting a human face to it may help and inspire our readers.…”

Osteoporose in Zeiten der COVID-19-Pandemie

“…Bei einer geschätzten Mortalität von 6,5 % (5%-9 %) sind etwa 680000 bereits daran verstorben [1]. Die Mortalität wird hervorgerufen durch ein schweres akutes Lungenversagen, verursacht durch das Coronavirus 2 (SARS-CoV-2), welches zuerst Ende 2019 in Wuhan, China, beobachtet worden war [2]…”