Association Between COVID-19 and Osteoporosis: A Bidirectional Mendelian Randomization Study

Abstract

Objective: The prevalence and severity of covid-19 infection were higher in patients with osteoporosis than in healthy controls, and the mean BMD was lower in patients with COVID-19 than in healthy controls, and low vitamin D levels were associated with the development of osteoporosis and the severity of COVID-19. The objective of this study is to understand whether there was indeed a bidirectional causal relationship between osteoporosis and COVID-19. Methods: Analysis of the causal relationship between the two through a two-way Mendelian pathway. Finding disease-related Single nucleotide Polymorphism as working variables through the Genome-wide association study database. The primary analysis for the Mendelian randomization (MR) study was the inverse variance weighting (IVW) method. The pleiotropy was estimated through the intercept from MR-Egger regression, and heterogeneity was assessed through Cochran’s Q test in IVW approach. Results: In the forward MR analysis, neither exposure to COVID-19 infection, hospitalization or severe infection was significantly associated with osteoporosis or drug-induced osteoporosis outcome (P>0.05); in the reverse MR analysis, exposures to osteoporosis was not significantly associated with COVID-19 outcomes (infection, hospitalization, severe case) (P>0.05). Conclusion: There was no significant relationship between COVID-19 patients and osteoporosis or drug-induced osteoporosis by genetic prediction.