Osteoporose-Management während der COVID-19 Pandemie

Abstract

Aim The COVID-19 pandemic has influenced the management of many chronic conditions including osteoporosis as resources are re-allocated to urgent care.

Methods This mini-review summarizes the effects of COVID-19 on diagnosis and management of osteoporosis. Evidence regarding possible effects of osteoporosis medications on COVID-19 outcomes and the relationship of COVID-19 vaccination to osteoporosis care is reviewed. Finally, initiation and maintenance of osteoporosis treatment during the pandemic are highlighted.

Results The use of standard procedures for the diagnosis of osteoporosis and assessment of fracture risk significantly decreased during the COVID-19 pandemic, while the incidence of fragility fractures was mostly unaltered. Both COVID-19 per se and its treatments are associated with a negative impact on bone health. Osteoporosis medications do not aggravate the clinical course of COVID-19, while preclinical data suggests possible beneficial effects of some therapies. While vitamin D deficiency is clearly associated with a worse clinical course of COVID-19, evidence of outcome improvement through vitamin D supplementation is lacking. Osteoporosis treatment should not be generally discontinued, and recommendations for substituting therapies are available. Osteoporosis therapies do not interfere with the efficacy or side-effect profiles of COVID-19 vaccines and should not be stopped or indefinitely delayed because of vaccination.

Conclusion The diagnosis and management of osteoporosis are challenging during the COVID-19 pandemic. Osteoporosis medications are safe and effective and should be continued. Further studies will elucidate the impact of the COVID-19 pandemic on long-term bone health.

Zusammenfassung

Ziel Die COVID-19-Pandemie hat die Behandlung vieler chronischer Erkrankungen, einschließlich Osteoporose, beeinflusst, da Ressourcen für die Notfallversorgung umgewidmet wurden.

Methoden Dieser Übersichtsartikel fasst zusammen die Auswirkungen von COVID-19 auf das Management der Osteoporose. Mögliche Effekte von Osteoporose-Medikamenten auf die COVID-19-Verläufe sowie die Beziehung zwischen COVID-19-Impfung und Osteoporose-Behandlung werden evaluiert. Schließlich wird die Einleitung und Fortsetzung der Osteoporose-Behandlung während der Pandemie diskutiert.

Ergebnisse Die Osteoporose-Diagnostik ging in den frühen Phasen der COVID-19-Pandemie deutlich zurück, während die Inzidenz von Fragilitätsfrakturen weitgehend unverändert blieb. Sowohl COVID-19 an sich als auch seine Behandlung sind mit potentiellen negativen Auswirkungen auf die Knochengesundheit verbunden. Osteoporose-Medikamente aggravieren nicht den klinischen Verlauf von COVID-19, während präklinische Daten auf mögliche positive Auswirkungen einiger Substanzen hinweisen. Obwohl ein Vitamin-D-Mangel eindeutig mit schweren klinischen Verläufen von COVID-19 einhergeht, gibt es keine Evidenz für eine Verbesserung der Erkrankung durch eine Vitamin-D-Supplementation. Die Osteoporose-Behandlung sollte generell nicht abgebrochen werden. Osteoporose-Medikamente beeinträchtigen weder die Wirksamkeit noch das Nebenwirkungsprofil der COVID-19-Impfstoffe und sollten wegen der Impfung nicht unterbrochen werden.

Schlussfolgerung Die Diagnose und Behandlung der Osteoporose während der COVID-19-Pandemie stellt eine Herausforderung dar. Osteoporose-Medikamente sind sicher und wirksam und sollten nach Möglichkeit weiter eingenommen werden. Weitere Studien werden mehr Aufschluss über die Auswirkungen der COVID-19-Pandemie auf die langfristige Knochengesundheit geben.

Schlüsselwörter

COVID-19 - SARS-CoV2 - Osteoporose - Frakturen - Impfung

Key words

COVID-19 - SARS-CoV2 - osteoporosis - fractures - vaccination

Publication History

Received: 27 October 2021

Accepted: 01 December 2021

Article published online:
21 February 2022

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