Anti-osteoporotic treatment and COVID-19 risk: is there an association?

Abstract

Introduction. Despite the recent ASBMR, AACE, Endocrine Society, ECTS&NOF guidelines for osteoporosis management in the era of COVID-19 the impact of antiosteoporotic drugs on disease risk and severity is insufficiently studied. The purpose of this study was to assess the COVID-19 risk for the patients receiving the parenteral bisphosphonate or Denosumab treatment, and the severity of its course in patients with systemic osteoporosis. Materials and methods. We performed the phone survey and studied the results of 195 patients (92 % women; mean age – 62.7 ± 10.8 years) with systemic osteoporosis depending on the current use of parenteral antiresorptive drugs (Zoledronic, Ibandronic acids, or Denosumab, n = 125) and compared the results with data of the patients with osteoporosis who did not use any anti-osteoporotic drugs previously (n = 70). Results. The group of patients with COVID-19 included 32.9 % of patients who did not receive previously any anti-osteoporotic treatment and 33.3 % of osteoporotic patients treated with parenteral antiresorptive drugs. The share of the patients taking the Zoledronic acid who fell ill with COVID-19 was 29.2 %, the share of those ta­king the Ibandronic acid was 34.4 %, and the share of those taking Denosumab was 42.9 %. We did not reveal any significant differences in the COVID-19 frequency and severity depending on the presence and type of parenteral anti-osteoporotic therapy. Additionally, there were no differences depen­ding on the patients' age, gender, obesity, and other osteoporosis risk factors. The risk of COVID-19 in the patients with systemic osteoporosis did not differ depending on antiresorptive drug use, amounting (odds ratio (OR) 95 % CI) 1.1 (0.6-2.0), or on the use of the definite anti-osteoporotic drug (for the Zoledronic acid – 0.9 (0.4-2.0), the Ibandronic acid – 1.1 (0.5-2.3), and for the Denosumab – 1.6 (0.5-5.2). Conclusions. Parenteral anti-osteoporo­tic drugs (Zoledronic acid, Ibandronic acid, or Denosumab) do not have any influence on COVID-19 frequency and severity and can be recommended for the continuation of the treatment of patients with osteoporosis.