SARS-CoV-2 and its Multifaceted Impact on Bone Health: Mechanisms and Clinical Evidence,Current Osteoporosis Reports

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SARS-CoV-2 and its Multifaceted Impact on Bone Health: Mechanisms and Clinical Evidence
Current Osteoporosis Reports ( IF 4.2 ) Pub Date : 2024-01-18 , DOI: 10.1007/s11914-023-00843-1
Alexander Harris ₁ , Amy Creecy ₁ , Olatundun D Awosanya ₁ , Thomas McCune _{2,

3} , Marie V Ozanne ₄ , Angela J Toepp _{2,

5} , Melissa A Kacena _{1,

6} , Xian Qiao _{2,

7,

8}

Affiliation

Purpose of Review

SARS-CoV-2 infection, the culprit of the COVID-19 pandemic, has been associated with significant long-term effects on various organ systems, including bone health. This review explores the current understanding of the impacts of SARS-CoV-2 infection on bone health and its potential long-term consequences.

Recent Findings

As part of the post-acute sequelae of SARS-CoV-2 infection, bone health changes are affected by COVID-19 both directly and indirectly, with multiple potential mechanisms and risk factors involved. In vitro and preclinical studies suggest that SARS-CoV-2 may directly infect bone marrow cells, leading to alterations in bone structure and osteoclast numbers. The virus can also trigger a robust inflammatory response, often referred to as a "cytokine storm", which can stimulate osteoclast activity and contribute to bone loss. Clinical evidence suggests that SARS-CoV-2 may lead to hypocalcemia, altered bone turnover markers, and a high prevalence of vertebral fractures. Furthermore, disease severity has been correlated with a decrease in bone mineral density. Indirect effects of SARS-CoV-2 on bone health, mediated through muscle weakness, mechanical unloading, nutritional deficiencies, and corticosteroid use, also contribute to the long-term consequences. The interplay of concurrent conditions such as diabetes, obesity, and kidney dysfunction with SARS-CoV-2 infection further complicates the disease's impact on bone health.

Summary

SARS-CoV-2 infection directly and indirectly affects bone health, leading to potential long-term consequences. This review article is part of a series of multiple manuscripts designed to determine the utility of using artificial intelligence for writing scientific reviews.

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