Influence of anti-osteoporosis treatments on the incidence of COVID-19 in patients with non-inflammatory rheumatic conditions.

Josep Blanch-Rubió,Rafael Maldonado,Jordi Monfort,Manuel Ciria-Recasens,Jone Llorente-Onaindia,Natalia Soldevila-Domenech,Rafael De La Torre,Laura Tío,The Covidmar Study Group,Luciano Polino,Alba Gurt

doi:10.18632/aging.104117

Abstract

Coronavirus disease 19 (COVID-19) is currently a global pandemic that affects patients with other pathologies. Here, we investigated the influence of treatments for osteoporosis and other non-inflammatory rheumatic conditions, such as osteoarthritis and fibromyalgia, on COVID-19 incidence. To this end, we conducted a cross-sectional study of 2,102 patients being treated at the Rheumatology Service of Hospital del Mar (Barcelona, Spain). In our cohort, COVID-19 cumulative incidence from March 1 to May 3, 2020 was compared to population estimates for the same city. We used Poisson regression models to determine the adjusted relative risk ratios for COVID-19 associated with different treatments and comorbidities. Denosumab, zoledronate and calcium were negatively associated with COVID-19 incidence. Some analgesics, particularly pregabalin and most of the studied antidepressants, were positively associated with COVID-19 incidence, whereas duloxetine presented a negative association. Oral bisphosphonates, vitamin D, thiazide diuretics, anti-hypertensive drugs and chronic non-steroidal anti-inflammatory drugs had no effect on COVID-19 incidence in the studied population. Our results provide novel evidence to support the maintenance of the main anti-osteoporosis treatments in COVID-19 patients, which may be of particular relevance to elderly patients affected by the SARS-CoV-2 pandemic.

Highlights

Infections by SARS-CoV-2, a novel coronavirus that emerged in China in late 2019 [1], and the disease that it causes, COVID-19, became a global pandemic on March 11th, 2020 [2]
The present study reveals that the main treatments currently used for osteoporosis are not associated with an increase in COVID-19 incidence
All the treatments analyzed in our study were continued after the presentation of COVID-19 symptoms following the www.aging-us.com recommendations of multiple international rheumatology [13, 14] and bone field organizations [15, 16]

Summary

Introduction

Infections by SARS-CoV-2, a novel coronavirus that emerged in China in late 2019 [1], and the disease that it causes, COVID-19, became a global pandemic on March 11th, 2020 [2]. In Spain, the area of Barcelona (Catalonia, Spain) has suffered one of the highest rates of incidence and deaths in Europe, mostly between March and April of 2020 [4]. The progression of the disease has been associated with a hyper inflammatory response with high levels of inflammatory markers and proinflammatory cytokines, sometimes accompanying a pro-coagulation state. Patients following this evolution sometimes become seriously ill, often requiring admission to Intensive Care Units, and some may die [5]

Methods

Results

Conclusion