Endocrine Abstracts

We conducted a survey during the first pandemic wave of coronavirus disease 2019 (COVID-19) on a large group of osteoporotic patients to evaluate the general conditions of osteoporotic patients and the impact of the pandemic on the management of osteoporosis, finding high compliance to treatments and low COVID-19 lethality. In a telephone survey conducted from April to May 2020, patients from the Osteoporosis Center, Clinic of Endocrinology and Metabolic Diseases of Umberto I Hospital (Ancona, Italy) were interviewed.

Results: Of a total of 910 interview subjects, 892 provided consent to participate in the survey (response rate 98%), including 785 women (88%) and 107 men (12%) Among the 892 patients interviewed, 77.9% were taking osteoporosis treatment and 94.6% vitamin D supplementation as prescribed at the last visit. COVID-19-like symptoms were reported by 5.1% (44 subjects), whereas confirmed cases were 1.2% (10 patients). A total number of 33 patients had been in hospital and the hospitalization rate of those who had not discontinued vitamin D supplementation was less than 4%. There were eight deaths, two with a concomitant COVID-19 diagnosis. The COVID-19 patients (10, all female) were significantly older than non-COVID-19 subjects (79.9±8.1 vs 70.8±11.4 years, P=0.01) but showed no significant differences in terms of comorbidities. The 2 patients who died of COVID-19 infection were both female; their family members said they were taking vitamin D, although dosing just before the lock down indicated vitamin D deficiency. The prevalence of severe osteoporosis was 50% in total COVID-19 patients and 87.5% in deceased COVID-19 patients. The overall COVID-19 mortality was 0.2%; lethality was 20%, lower than the national rate of the same age group. According to the logistic regression model considering only vitamin D supplementation, the supplement had a protective effect against the risk of hospitalization (OR 0.31, CI 0.11-0.84,P=0.02).

Conclusions: Our frail patients followed up by phone felt reassured, they showed high treatment compliance, and experienced a lower COVID-19 lethality rate than patients of the same age; those who had not discontinued their vitamin D supplement also had a reduced hospitalization rate. The results of our survey, support a possible protective role of vitamin D against severity of COVID-19. The study moreover highlighted the critical value of telemedicine in the context of the pandemic as well as in the routine monitoring and care of old and frail patients and of those with chronic disease.