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

Aging (Albany NY). 2020 Oct 20;12(20):19923-19937. doi: 10.18632/aging.104117. Epub 2020 Oct 20.

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.

Keywords: COVID-19; anti-resorptive drugs; calcium; denosumab; vitamin D; zoledronate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Density Conservation Agents / therapeutic use*
  • COVID-19
  • Calcium / therapeutic use*
  • Coronavirus Infections / chemically induced
  • Coronavirus Infections / epidemiology*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / chemically induced
  • Pneumonia, Viral / epidemiology*
  • Rheumatic Diseases / complications*
  • Rheumatic Diseases / drug therapy
  • Spain / epidemiology
  • Vitamin D / therapeutic use*

Substances

  • Bone Density Conservation Agents
  • Vitamin D
  • Calcium