Clinical outcomes of COVID-19 infection in patients with osteoporosis: a nationwide cohort study in Korea using the common data model

Sci Rep. 2024 Jul 31;14(1):17738. doi: 10.1038/s41598-024-68356-0.

Abstract

Many older patients with COVID-19 likely have co-morbid osteoporosis. We investigated the clinical outcomes of COVID-19 patients with osteoporosis. This was a retrospective cohort study using national claims data from Korea encoded in the common data model. Patients aged ≥ 50 years diagnosed with COVID-19 infection between January 2020 and April 2022 were included and stratified into two groups according to a history of osteoporosis. Clinical outcomes of COVID-19 infection were analyzed using logistic regression analysis after large-scale propensity score stratification. Of the 597,011 patients with COVID-19 included in the study, 105,172 had a history of osteoporosis. In patients with a history of osteoporosis, the odds of mortality decreased (odds ratio [OR] 0.82, P < 0.002), whereas most clinical outcomes of COVID-19 did not exhibit differences compared to those without such a history. Osteoporosis patients with a history of fractures showed increased odds of pneumonia, hospitalization, major adverse cardiac events, venous thromboembolism, and mortality, compared to patients without osteoporosis (ORs 1.34-1.58, P < 0.001 to P = 0.001). Our study suggests that patients with severe osteoporosis who have experienced fractures have an elevated risk of severe complications with COVID-19, while osteoporosis patients without fractures who have sought medical attention have a lower risk of mortality.

Keywords: COVID-19; Fractures; Mortality; Osteoporosis.

MeSH terms

  • Aged
  • Aged, 80 and over
  • COVID-19* / complications
  • COVID-19* / epidemiology
  • COVID-19* / mortality
  • Cohort Studies
  • Comorbidity
  • Female
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Osteoporosis* / complications
  • Osteoporosis* / epidemiology
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2 / isolation & purification