Department of Orthopaedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China.
Orthopaedics Research Institute of Zhejiang University, Zhejiang, China.
J Glob Health. 2024 Oct 18;14:05029. doi: 10.7189/jogh.14.05029.
In this study, we aimed to identify bone mineral density (BMD) trajectories of hospitalised patients with coronavirus disease 2019 (COVID-19) and to determine the prognostic role of the trajectory groups.
This is a retrospective study of hospitalised patients with COVID-19 treated in our hospital from November 2022 to February 2023. BMD was manually measured from the thoracic 12 (T12) and lumbar one (L1) vertebra using chest computed tomography images. We constructed group trajectory models using group-based trajectory modelling. We performed the logistic regression analysis to associate the BMD trajectory pattern with clinical outcomes.
This study included 1767 patients. The mean follow-up time after discharge was 181.5 days (standard deviation (SD) = 9.7). There were 1137 (64.3%) male patients, and more than 80% of patients were aged >60 years. We successfully identified three latent BMD trajectories to reveal the dynamic effects of COVID-19 infection on bone health in patients, namely, the early low-normal decline group, the average, and the early high-rapid decline group. All groups demonstrated consistent overall declining trends. A significant association was observed between BMD trajectory pattern (T12 or L1) and baseline characteristics of sex, age, and penetrating keratoplasty (P < 0.05). Our study showed that the BMD trajectories were significantly associated with mortality. Furthermore, we found that these trajectories were also associated with the length of hospital stay.
This study provided evidence for the COVID-19 process to bone health, as well as evidence on strengthening bone health management before and after COVID-19 infection. BMD trajectories may help manage bone health and guide treatment in patients with COVID-19.
本研究旨在确定住院的 2019 冠状病毒病（COVID-19）患者的骨密度（BMD）轨迹，并确定轨迹组的预后作用。
这是一项回顾性研究，纳入了 2022 年 11 月至 2023 年 2 月在我院住院治疗的 COVID-19 患者。使用胸部计算机断层扫描图像手动测量 T12 和 L1 椎体的 BMD。我们使用基于群组的轨迹建模构建群组轨迹模型。我们进行了逻辑回归分析，将 BMD 轨迹模式与临床结局相关联。
这项研究共纳入了 1767 例患者。出院后平均随访时间为 181.5 天（标准差（SD）=9.7）。1137 例（64.3%）为男性患者，80%以上的患者年龄>60 岁。我们成功确定了三种潜在的 BMD 轨迹，以揭示 COVID-19 感染对患者骨骼健康的动态影响，即早期低正常下降组、平均组和早期高快速下降组。所有组均表现出一致的总体下降趋势。BMD 轨迹模式（T12 或 L1）与性别、年龄和穿透性角膜移植术的基线特征显著相关（P<0.05）。我们的研究表明，BMD 轨迹与死亡率显著相关。此外，我们发现这些轨迹与住院时间长短也显著相关。
本研究为 COVID-19 对骨骼健康的影响提供了证据，也为 COVID-19 感染前后加强骨骼健康管理提供了证据。BMD 轨迹可能有助于管理 COVID-19 患者的骨骼健康并指导治疗。
