Abstract
SummaryWe investigated whether osteoporotic fractures declined during lockdown, among adults aged 50 years and older. We showed that fewer outpatients attended the Fracture Clinic, for non-hip fractures, during lockdown; in contrast, no change in admissions for hip fractures was observed. This could be due to fewer outdoors falls, during lockdown.PurposeMany countries implemented a lockdown to control the spread of the COVID-19 pandemic. We explored whether outpatient attendances to the Fracture Clinic for non-hip fragility fracture and inpatient admissions for hip fracture declined during lockdown, among adults aged 50 years and older, in a large secondary care hospital.MethodsIn our observational study, we analysed the records of 6681 outpatients attending the Fracture Clinic, for non-hip fragility fractures, and those of 1752 inpatients, admitted for hip fracture, during the time frames of interest. These were weeks 1st to 12th in 2020 (“prior to lockdown”), weeks 13th to 19th in 2020 (“lockdown”) and corresponding periods over 2015 to 2019. We tested for differences in mean numbers (standard deviation (SD)) of outpatients and inpatients, respectively, per week, during the time frames of interest, across the years.ResultsPrior to lockdown, in 2020, 63.1 (SD 12.6) outpatients per week attended the Fracture Clinic, similar to previous years (p value 0.338). During lockdown, 26.0 (SD 7.3) outpatients per week attended the Fracture Clinic, fewer than previous years (p value < 0.001); similar findings were observed in both sexes and age groups (all p values < 0.001). During lockdown, 16.1 (SD 5.6) inpatients per week were admitted for hip fracture, similar to previous years (p value 0.776).ConclusionDuring lockdown, fewer outpatients attended the Fracture Clinic, for non-hip fragility fractures, while no change in inpatient admissions for hip fracture was observed. This could reflect fewer non-hip fractures and may inform allocation of resources during pandemic.
Highlights
In December 2019, a novel coronavirus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged and caused a pandemic [1]
COVID-19, the disease caused by SARS-CoV-2, is characterised by fever, respiratory symptoms as well as fatigue, myalgia, dizziness and delirium [1, 2]
The aim of this study was to investigate whether lockdown may be associated with a reduction in the number of older outpatients attending the Fracture Clinic, for any type of acute non-hip fragility fractures and reduction in inpatient hospital admissions for acute hip fracture, in a large secondary care hospital, compared with corresponding periods, across previous years
Summary
In December 2019, a novel coronavirus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged and caused a pandemic [1]. Tuesday 12th May 2020, with a subsequent relaxation of the rules [3] It is unknown whether the restriction of outdoor movements imposed by the lockdown may affect the incidence of osteoporotic fragility fractures, by potentially reducing the number of outdoor falls and subsequent fractures, among older adults [4,5,6,7]. This effect could be pronounced on non-hip fragility fractures (including forearm, upper arm, ankle, foot and others), compared with hip fractures. COVID-19, and its associated symptoms of fatigue, dizziness and delirium, could contribute to falls and fractures among older people
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