The COVID-19 Pandemic Has Had a Major Impact on Osteoporosis Management

In one way or another, the COVID-19 pandemic has affected every corner of health care. And according to a study, this includes the management of osteoporosis, which may have sustained significant adverse effects. From February through April, the researchers observed a significant decline in worldwide use of the Fracture Risk Assessment Tool (FRAX) website.

“As a global tool the FRAX website provides an excellent opportunity to explore the impact of the COVID-19 pandemic on osteoporosis, a major non-communicable disease (NCD) with a significant impact on older adults worldwide,” said lead study author Professor Eugene McCloskey, professor in adult bone disease at the Department of Oncology and Metabolism, University of Sheffield, UK, in a press release. “The findings of this study reveal that, since the pandemic was officially declared by the [World Health Organization] on March 11, there has been a dramatic drop in FRAX usage, averaging 58% but ranging up to 96%, with two-thirds of the 66 countries/territories evaluated showing reductions by at least 50%.”

The researchers retrospectively reviewed GoogleAnalytics data on daily FRAX website sessions from November 2019 through April 2020, with a main focus on February through April.

Between February and April, 460,495 sessions from 184 countries were recorded; February alone saw 210,656 sessions. In March, the number of sessions declined by 23.1%, and in April, by 58.3%. This was not observed in 2019, the researchers noted.

Asia had smaller reductions compared to other places. Three-quarters of European countries (n=24/31; 77.4%) reduced usage by at least half in April; in the countries whose reductions were less than 50% (Poland, Slovakia, Czech Republic, Germany, Norway, Sweden, and Finland), reductions ranged from 2.85% to 44.10%. FRAX usage did not appear to be correlated with measures of disease burden, “such as COVID-attributed deaths per million of the population,” said the study authors.

“The drastic reduction in FRAX usage underscores widespread concern that the COVID-19 pandemic is having a detrimental impact on the medium to long-term management and outcomes for many NCDs, with serious repercussions for individuals who are not able to access timely testing and treatment, including for osteoporosis,” said study author Professor John Kanis, honorary president of the International Osteoporosis Foundation, director of the Centre for Metabolic Bone Diseases at Sheffield, and professor at the Catholic University of Australia. “Availability and access to bone densitometry in many countries is low to begin with, and access to secondary care-based facilities such as Fracture Liaison Services has been further comprised or inhibited completely during the pandemic. We expect that FRAX, which can be undertaken remotely via telemedicine and has been shown to have a predictive value for fractures that is comparable to the use of bone density values alone, may be able to play a significant role in addressing this enormous backlog in assessments for osteoporosis.”

The study was published in Osteoporosis International.