Radiological Thoracic Vertebral Fractures are Highly Prevalent in COVID-19 and Predict Disease Outcomes

Abstract Context and Objective COVID-19 has become the most relevant medical issue globally. Despite several studies that have investigated clinical characteristics of COVID-19 patients, no data have been reported on the prevalence of vertebral fractures (VFs). Since VFs may influence cardiorespirat...

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Vydáno v:The journal of clinical endocrinology and metabolism Ročník 106; číslo 2; s. e602 - e614
Hlavní autoři: di Filippo, Luigi, Formenti, Anna Maria, Doga, Mauro, Pedone, Erika, Rovere-Querini, Patrizia, Giustina, Andrea
Médium: Journal Article
Jazyk:angličtina
Vydáno: US Oxford University Press 01.02.2021
Copyright Oxford University Press
Témata:
Aged
Cardiovascular disease
Chest
Clinical
Cohort Studies
Comorbidity
Coronary artery disease
Coronary heart disease
COVID-19
COVID-19 - complications
COVID-19 - diagnosis
COVID-19 - epidemiology
Emergency medical care
Female
Fractures
Heart diseases
Humans
Hypertension
Italy - epidemiology
Male
Mechanical ventilation
Medical research
Medicine, Experimental
Middle Aged
Mortality
Patients
Prevalence
Prevalence studies (Epidemiology)
Prognosis
Radiography, Thoracic - statistics & numerical data
Retrospective Studies
SARS-CoV-2 - physiology
Severity of Illness Index
Spinal Fractures - complications
Spinal Fractures - diagnosis
Spinal Fractures - diagnostic imaging
Spinal Fractures - epidemiology
Thoracic Vertebrae - diagnostic imaging
Thoracic Vertebrae - injuries
Thoracic Vertebrae - pathology
Thorax
Vertebrae
X-rays
Italy
COVID-19
SARS-CoV-2
bone metabolism
osteoporosis
vertebral fractures
ISSN:0021-972X, 1945-7197, 1945-7197
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Shrnutí:Abstract Context and Objective COVID-19 has become the most relevant medical issue globally. Despite several studies that have investigated clinical characteristics of COVID-19 patients, no data have been reported on the prevalence of vertebral fractures (VFs). Since VFs may influence cardiorespiratory function and disease outcomes, the aim of this study was to assess VFs prevalence and clinical impact in COVID-19. Design and Patients This was a retrospective cohort study performed at San Raffaele Hospital, a tertiary health care hospital in Italy. We included COVID-19 patients for whom lateral chest x-rays at emergency department were available. VFs were detected using a semiquantitative evaluation of vertebral shape on chest x-rays. Results A total of 114 patients were included in this study and thoracic VFs were detected in 41 patients (36%). Patients with VFs were older and more frequently affected by hypertension and coronary artery disease (P < 0.001, P = 0.007, P = 0.034; respectively). Thirty-six (88%) patients in VFs+ group compared to 54 (74%) in VFs− group were hospitalized (P = 0.08). Patients with VFs more frequently required noninvasive mechanical ventilation compared with those without VFs (P = 0.02). Mortality was 22% in VFs+ group and 10% in VFs− group (P = 0.07). In particular, mortality was higher in patients with severe VFs compared with those with moderate and mild VFs (P = 0.04). Conclusions VFs may integrate the cardiorespiratory risk of COVID-19 patients, being a useful and easy to measure clinical marker of fragility and poor prognosis. We suggest that morphometric thoracic vertebral evaluation should be performed in all suspected COVID-19 patients undergoing chest x-rays.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0021-972X
1945-7197
1945-7197
DOI:10.1210/clinem/dgaa738