Management of osteoporosis and calcium metabolism disorders during COVID-19 pandemics
Authors:
Smaha Juraj; Kužma Martin; Jackuliak Peter; Killinger Zdenko; Payer Juraj
Authors‘ workplace:
V. interná klinika LF UK a UNB, Nemocnica Ružinov, Bratislava
Published in:
Clinical Osteology 2020; 25(1): 28-34
Category:
Overview
During the COVID-19 crisis it is very important for people with osteoporosis and calcium metabolism disorders to prevent fractures and to have guidance and support in managing their diseases. Osteologists have to make rapid changes to services in order to help prevent spread of the virus while maintaining best clinical practice possible. Non-urgent appointments should be postponed, remote consultations should be promoted and patients should be empowered to self-manage their conditions safely. Management of patients on specific parenteral antiporotic treatments could be problematic. IV bisphosphonates infusions can be delayed for at least 6–9 months during the pandemics. Patients on denosumab should continue planned therapy, if more than 7 months have passed after last denosumab administration alternative management with oral bisphosphonates should be followed quickly because of immediate increased risk of fracture. Vitamin D supplementation may probably protect patients from viral respiratory infections and alleviate the course of disease. Many diagnostic and therapeutic interventions of patients with hypo- or hyperparathyroidism should be postponed and most of the patients should be managed via remote consultations.
Keywords:
hyperparathyroidism – denosumab – COVID-19 – osteoporosis – pandemics – vitamin D – zoledronic acid
Sources
Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun 2020; 109: 102433. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jaut.2020.102433>.
Rosenbaum L. The Untold Toll – The Pandemic´s Effect on Patients without COVID-19. N Eng J Med 2020. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMms2009984>.
Lurie N, Saville M, Hatchett R et al. Developing Covid-19 vaccines at pandemic speed. N Eng J Med 2020; 382(21): 1969–1973. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMp2005630>.
Payer J, Jackuliak P, Smaha J. Metodické usmernenie hlavného odborníka MZSR pre endokrinológiu: Manažment vybraných ochorení endokrinného systému u dospelých v čase pandémie COVID-19. Dostupné z WWW: <http://www.endo.sk/images/news/Odporucania_1.verzia_modif.pdf>.
Martineau AR, Jolliffe DA, Hooper RL et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ 2017; 356; i6583. Dostupné z DOI: <http://dx.doi.org/10.1136/bmj.i6583>.
Daneshkhah A, Vasundhara A, Eshein A et al. The possible role of vitamin D in suppressing cytokine storm and associated mortality in COVID-19 patients. medRxiv 2020 (preprint). Dostupné z DOI: <http://dx.doi.org/10.1101/2020.04.08.20058578>.
Dancer RCA, Parekh D, Lax S et al. Vitamin D deficiency contributes directly to the acute respiratory distress syndrome (ARDS). Thorax 2015; 70(7): 617–624. Dostupné z DOI: <http://dx.doi.org/10.1136/thoraxjnl-2014–206680>.
Ilie PC, Stefanescu S, Smith L. The role of vitamin D i the prevention of coronavirus disease 2019 infection an mortality. Aging Clin Exp Res 2020; 1–4. Dostupné z DOI: <http://dx.doi.org/doi.org/10.1007/s40520020–01570–8>.
Alipio M. Vitamin D supplementation could possibly improve clinical outcomes of patients infected with coronavirus-2019 (COVID-2019). SSRN 3571484. Dostupné z DOI: <http://dx.doi.org/10.2139/ssrn.3571484>.
Grant WB, Lahore H, McDonnell Sl et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients 2020; 12(4): E988. Dostupné z DOI: <http://dx.doi.org/10.3390/nu12040988>.
Spieza L, Boscolo A, Poletto F et al. COVID-19 related severe hypercoagulability in patients admitted to intensive care unit for acute respiratory failure. Thromb Haemost 2020. Dostupné z DOI: <http://dx.doi.org/10.1055/s-0040–1710018>.
Joint Guidance on Osteoporosis Management in the Era of COVID-19 from the American Society for Bone and Mineral Research (ASBMR), American Association of Clinical Endocrinologists (AACE), Endocrine Society, European Calcified Tissue Society (ECTS) and National Osteoporosis Foundation (NOF). Coalition of the Bone Health Experts 2020; 1–3. Dostupné z WWW: <https://cdn.nof.org/wp-content/uploads/Joint-Statement-on-COVID19-and-Osteoporosis-Final.pdf>.
Gonzalez-Rodriguez E, Aubry-Rozier B, Stoll D et al. Sixty spontaneous vertebral fractures after denosumab discontinuation in 15 women with early-stage breast cancer under aromatase inhibitors. Breast Cancer Res Treat 2020; 179(1): 153–159. Dostupné z DOI: <http://dx.doi.org/10.1007/s10549–019–05458–8>.
Vaňuga P, Killinger Z, Jackuliak P et al. Odporúčanie SOMOK: Dlhodobá liečba osteoporózy denosumabom. Clin Osteol 2019; 24(4): 216–217.
Leder BZ, Neer RM, Wyland JJ et al. Effects of teriparatid treatment and discontinuation in postmenopausal women and eugonadal men with osteoporosis. J Clin Endocrinol Metab 2009; 94(8): 2915–2921. Dostupné z DOI: <http://dx.doi.org/10.1210/jc.2008–2630>.
Grey A, Bolland MJ, Horne A et al. Duration of antiresorptive activity of zoledronate in postmenopausal women with osteopenia: a randomized, controlled multidose trial. CMAJ 2017; 189(36): E1130-E1136. Dostupné z DOI: <http://dx.doi.org/10.1503/cmaj.161207>.
Reid IR, Horne AM, Mihov B et al. Fracture prevention with zoledronate in older women with osteopenia. N Eng J Med 2018; 379(25): 2407–2416. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1808082>.
Postponement of zoledronic acid infusions – letter template. University Hospitals Birmingham 2020; 1–2. Dostupné z WWW: <https://www.endocrinology.org/clinical-practice/covid-19-resources-for-managing-endocrine-conditions/>.
Gittoes N, Criseno S, Appelman-Dijkstra NM et al. Endocrinology in the time of COVID-19: Management of calcium disorders and osteoporosis. Eur J Endocrinol 2020; EJE-20–0385. Dostupné na DOI: <http://dx.doi.org/10.1530/EJE-20–0385>.
Turner J, Gittoes N, Selby P. Society for endocrinology endocrine emergency guidance: Emergency management of acute hypocalcaemia in adult patients. Endocr Connect 2016; 5(5): G7-G8. Dostupné na DOI: <http://dx.doi.org/10.1530/EC-16–0056>.
British Association of Endocrine and Thyroid Surgeons Executive Board: Prioritisation advice for Adults Endocrine Surgery during COVID-19 crisis. 2020; 1. Dostupné z WWW: https://www.baets.org.uk/wp-content/uploads/2020/05/BAETS-Prioritisation-Advice-Final-05-2020.pdf
Labels
Clinical biochemistry Paediatric gynaecology Paediatric radiology Paediatric rheumatology Endocrinology Gynaecology and obstetrics Internal medicine Orthopaedics General practitioner for adults Radiodiagnostics Rehabilitation Rheumatology Traumatology OsteologyArticle was published in
Clinical Osteology
2020 Issue 1
Most read in this issue
- Atypical cases of secondary hyperparathyroidism in patients with kidney disease and failure: case reports
- Guidelines for osteoporotic patients during COVID-19 pandemics
- Effect of anorexia nervosa on bone metabolism
- Management of osteoporosis and calcium metabolism disorders during COVID-19 pandemics