COVID-19 Pandemisinin Osteoporoz Tanı ve Takibi Üzerine Etkileri

Year 2025, Volume: 27 Issue: 2, 184 - 188, 30.08.2025

Ferda Surel , Esra Şahingöz Bakırcı , Gülseren Demir Karakılıç

https://doi.org/10.18678/dtfd.1616307

Abstract

Amaç: Koronavirüs hastalığı 2019 (coronavirus disease 2019, COVID-19) pandemisi, osteoporoz gibi birçok kronik hastalığın takip ve tedavi sürecini etkilemiştir. Bu çalışmanın amacı, osteoporoz tanısı alan hastaların 25-hidroksivitamin D (25(OH)D) düzeyleri ve kemik mineral yoğunluğu (KMY) ölçümlerinin COVID-19 pandemisi sırasında etkilenip etkilenmediğini belirleyerek takip ve tedavi protokollerindeki değişiklikleri saptamaktır.
Gereç ve Yöntemler: Çalışmaya 1 Aralık 2018 ile 1 Mart 2020 tarihleri arasında osteoporoz tanısı almış 598 hasta dahil edildi. Pandemi sonrası takip süresi, femur boynu T-skoru ve KMY değeri, lomber vertebra toplam (L1-4) T-skoru ve KMY değeri, 25(OH)D düzeyleri ve osteoporoz için uygulanan medikal tedaviler geriye dönük olarak kaydedildi.
Bulgular: Pandemi sonrası ortalama takip süresi 2 yıl olarak belirlendi. Pandemi sonrası dönemde 25(OH)D düzeyleri pandemi öncesine göre anlamlı olarak daha yüksekti (p<0,001). Lomber toplam T-skorları ve KMY değerleri, femur boynu T-skorları ve KMY değerleri pandemi öncesi dönemde daha yüksekti (hepsi için p<0,001). Osteoporoz tedavisinde pandemi sonrası dönemde denosumab kullanım sıklığında pandemi öncesi döneme göre istatistiksel olarak anlamlı bir artış saptandı (p<0,001).
Sonuç: Pandemi öncesi döneme kıyasla hasta takibinde gecikme, KMY ve T-skorlarında azalma, 25(OH)D düzeylerinde artış ve yalnızca denosumab ile tedavide artış gözlenmiştir. Özellikle sağlık hizmetlerine erişimin zorlaştığı dönemlerde, osteoporoz tanı ve takibi için uzaktan değerlendirme yöntemlerinin geliştirilmesi ve hasta eğitimi yoluyla tedavilerin evde mümkün olduğunca erişilebilir hale getirilmesi büyük önem taşımaktadır.

Keywords

COVID-19 , osteoporoz , pandemi , tedavi , D vitamini

The Effects of the COVID-19 Pandemic on the Diagnosis and Follow-up of Osteoporosis

Abstract

Aim: The coronavirus disease 2019 (COVID-19) pandemic has impacted the follow-up and treatment processes of many chronic diseases, including osteoporosis. This study aimed to determine whether 25-hydroxyvitamin D (25(OH)D) levels and bone mineral density (BMD) measurements in patients diagnosed with osteoporosis were affected during the COVID-19 pandemic to assess changes in follow-up and treatment protocols.
Material and Methods: The study included 598 patients diagnosed with osteoporosis between December 1, 2018, and March 1, 2020. The duration of follow-up after the pandemic, femoral neck T-score and BMD value, lumbar vertebrae total (L1-4) T-score and BMD value, 25(OH)D levels, and medical treatments for osteoporosis were recorded retrospectively.
Results: The mean duration of follow-up visits after the pandemic was nearly two years. 25(OH)D levels were significantly higher in the post-pandemic period than in the pre-pandemic period (p<0.001). Lumbar total T-scores and BMD values, femoral neck T-scores, and BMD values were higher in the pre-pandemic period (p<0.001 for all). There was a statistically significant increase in the frequency of denosumab use in the post-pandemic period compared to the pre-pandemic period in the treatment of osteoporosis (p<0.001).
Conclusion: There is a delay in follow-up of patients, a decrease in BMD and T-scores, an increase in 25(OH)D levels, and an increase in treatment only with denosumab compared to the pre-pandemic period. It is essential to develop remote assessment methods for diagnosing and monitoring osteoporosis, particularly when accessing health services is challenging, and to make treatments as accessible as possible at home through patient education.

Keywords

COVID-19 , osteoporosis , pandemic , treatment , Vitamin D

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