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Long-term effects of COVID-19 infection on bone mineral density
Zhan Wang1,2,3,4,5, Zilong Li1,2,3,4,5, Yechao Shen1,2,3,4,5
1Department of Orthopaedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China.
Insights
This study identified three bone mineral density (BMD) trajectories in hospitalized coronavirus disease 2019 (COVID-19) patients. These BMD patterns are linked to mortality and hospital stay duration, offering insights into COVID-19
Area of Science:
- Bone Metabolism and Endocrinology
- Infectious Diseases and Public Health
- Radiology and Imaging
Background:
- Hospitalized patients with coronavirus disease 2019 (COVID-19) may experience impacts on bone health.
- Understanding bone mineral density (BMD) changes during and after COVID-19 infection is crucial for patient management.
Purpose of the Study:
- To identify distinct bone mineral density (BMD) trajectories in hospitalized COVID-19 patients.
- To determine the prognostic significance of these BMD trajectory groups regarding clinical outcomes.
Main Methods:
- Retrospective analysis of 1767 hospitalized COVID-19 patients (Nov 2022-Feb 2023).
- Manual measurement of BMD from T12 and L1 vertebrae using computed tomography (CT) scans.
- Group-based trajectory modeling to identify BMD patterns and logistic regression for outcome association.
Main Results:
- Three latent BMD trajectories were identified: early low-normal decline, average, and early high-rapid decline.
- All identified BMD trajectories showed a consistent overall declining trend.
- BMD trajectory patterns were significantly associated with mortality and length of hospital stay.
Conclusions:
- COVID-19 infection influences bone health, with distinct BMD trajectory patterns observed.
- BMD trajectories can serve as prognostic indicators for hospitalized COVID-19 patients.
- Findings support the need for enhanced bone health management strategies before and after COVID-19 infection.
Background:
In this study, we aimed to identify bone mineral density (BMD) trajectories of hospitalised patients with coronavirus disease 2019 (COVID-19) and to determine the prognostic role of the trajectory groups.
Methods:
This is a retrospective study of hospitalised patients with COVID-19 treated in our hospital from November 2022 to February 2023. BMD was manually measured from the thoracic 12 (T12) and lumbar one (L1) vertebra using chest computed tomography images. We constructed group trajectory models using group-based trajectory modelling. We performed the logistic regression analysis to associate the BMD trajectory pattern with clinical outcomes.
Results:
This study included 1767 patients. The mean follow-up time after discharge was 181.5 days (standard deviation (SD) = 9.7). There were 1137 (64.3%) male patients, and more than 80% of patients were aged >60 years. We successfully identified three latent BMD trajectories to reveal the dynamic effects of COVID-19 infection on bone health in patients, namely, the early low-normal decline group, the average, and the early high-rapid decline group. All groups demonstrated consistent overall declining trends. A significant association was observed between BMD trajectory pattern (T12 or L1) and baseline characteristics of sex, age, and penetrating keratoplasty (P < 0.05). Our study showed that the BMD trajectories were significantly associated with mortality. Furthermore, we found that these trajectories were also associated with the length of hospital stay.
Conclusions:
This study provided evidence for the COVID-19 process to bone health, as well as evidence on strengthening bone health management before and after COVID-19 infection. BMD trajectories may help manage bone health and guide treatment in patients with COVID-19.
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