Association between bisphosphonate use and COVID-19 related outcomes

Area of Science:

• * Pharmacology and Infectious Disease Research
• * Epidemiology and Public Health

Background:

• * Insufficient COVID-19 vaccination rates globally necessitate exploring alternative therapeutic strategies.
• * Repurposing existing medications is crucial for managing high disease burden and preventing viral variant emergence.
• * This study investigates the potential of bisphosphonates in mitigating COVID-19 incidence and severity.

Purpose of the Study:

• * To evaluate the association between prior bisphosphonate use and the incidence of COVID-19.
• * To determine if bisphosphonate use impacts the severity of COVID-19, including hospitalization rates.
• * To explore the potential protective effects of bisphosphonates against SARS-CoV-2 and other respiratory infections.

Main Methods:

• * Retrospective cohort study using health insurance claims data from over 8.2 million patients.
• * Propensity score matching (1:1) to compare bisphosphonate users and non-users based on demographics and comorbidities.
• * Analysis of outcomes including SARS-CoV-2 testing, COVID-19 diagnosis, and hospitalization from March to June 2020.

Main Results:

• * Bisphosphonate users exhibited significantly lower odds of SARS-CoV-2 testing (OR=0.22), COVID-19 diagnosis (OR=0.23), and hospitalization (OR=0.26).
• * Sensitivity analyses confirmed these findings, indicating robustness of the observed associations.
• * Bisphosphonate use was also linked to reduced odds of pneumonia and acute bronchitis in the preceding year.

Conclusions:

• * Prior bisphosphonate use is strongly associated with reduced odds of COVID-19 diagnosis and hospitalization.
• * Findings suggest a potential protective role for bisphosphonates against respiratory infections, including COVID-19.
• * Further prospective clinical trials are warranted to establish causality.