Zhang Helen, Balmaceno-Criss Mariah, Fruge Abigail M, Massey Patrick A, Daniels Alan H, Zhang Andrew S
Department of Orthopaedic Surgery, The Warren Alpert Medical School, Brown University, Providence, RI 02903, USA.
School of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA.
J Clin Med. 2024 Dec 22;13(24):7830. doi: 10.3390/jcm13247830.
: Early studies have suggested that the SARS-CoV-2 virus has a deleterious effect on bone mineral density and may increase the risk of pathological fractures. This study characterized vertebral compression fractures in patients with and without a prior diagnosis of COVID-19. : Using a nationwide claims database, this retrospective study used ICD-10 billing codes to identify patients with a diagnosis of vertebral compression fracture from January 2020 to April 2022. Two cohorts were created based on whether the patients had a concurrent diagnosis of COVID-19. Patient demographics, comorbidities, and outcome measures were characterized by descriptive analysis. : In total, 413,425 patients met the inclusion criteria. Among them, a total of 23,148 patients (5.60%) had a diagnosis of COVID-19 at the time of their compression fracture. Among the COVID-19 patients, the incidences of vertebral compression fracture were 0.42% in 2020 and 0.33% in 2021, in comparison to the historical average yearly incidence of 0.17% across all patients. The patients with COVID-19 at the time of compression fracture diagnosis had a higher rate of vitamin D deficiency (OR: 1.25) and a lower rate of routine healing (OR: 0.61). The patients without COVID-19 were more likely to be osteoporotic (OR: 0.88), experience additional compression fractures (OR: 0.38), and have kyphoplasty or vertebroplasty (OR: 0.73). : Despite lower rates of osteoporosis, patients with a concomitant COVID-19 diagnosis exhibited a higher incidence of compression fractures. Although more research is needed, these results support increasing bone health surveillance in patients with a history of COVID-19 infection.
早期研究表明，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒对骨密度有不良影响，并可能增加病理性骨折的风险。本研究对有和没有新冠肺炎既往诊断的患者的椎体压缩性骨折进行了特征描述。：利用全国性索赔数据库，这项回顾性研究使用国际疾病分类第十版（ICD-10）计费代码，识别出2020年1月至2022年4月期间诊断为椎体压缩性骨折的患者。根据患者是否同时诊断为新冠肺炎创建了两个队列。通过描述性分析对患者的人口统计学特征、合并症和结局指标进行了描述。：共有413425名患者符合纳入标准。其中，共有23148名患者（5.60%）在发生压缩性骨折时被诊断为新冠肺炎。在新冠肺炎患者中，2020年椎体压缩性骨折的发病率为0.42%，2021年为0.33%，而所有患者的历史平均年发病率为0.17%。在诊断为压缩性骨折时患有新冠肺炎的患者维生素D缺乏率较高（比值比：1.25），常规愈合率较低（比值比：0.61）。没有新冠肺炎的患者更有可能患有骨质疏松症（比值比：0.88）、经历额外的压缩性骨折（比值比：0.38）以及接受椎体后凸成形术或椎体成形术（比值比：0.73）。：尽管骨质疏松症的发生率较低，但同时诊断为新冠肺炎的患者压缩性骨折的发生率较高。尽管还需要更多研究，但这些结果支持加强对有新冠肺炎感染史患者的骨骼健康监测。
