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Vertebral Fractures Marker of Poorer Prognosis in COVID-19

COVID-19 patients with vertebral fractures more often require noninvasive mechanical ventilation

Nurse with patient on respirator

WEDNESDAY, Oct. 21, 2020 (HealthDay News) -- Vertebral fractures (VFs) are a clinical marker of fragility and poor prognosis in patients with COVID-19, according to a study published online Oct. 21 in the Journal of Clinical Endocrinology & Metabolism.

Luigi di Filippo, M.D., from the Vita-Salute San Raffaele University in Milan, and colleagues examined the prevalence and clinical impact of VFs in COVID-19 in a retrospective cohort study. One hundred fourteen COVID-19 patients for whom lateral chest X-rays were available were included; a semi-quantitative evaluation of vertebral shape on chest X-ray was used to detect VFs.

The researchers detected thoracic VFs in 41 patients (36 percent). Patients with VFs were older and more frequently had hypertension and coronary artery disease. Hospitalization occurred in 88 versus 74 percent of patients with versus without VFs (P = 0.08). Compared with those without VFs, patients with VFs required noninvasive mechanical ventilation more frequently (P = 0.02). Mortality was 22 versus 10 percent in patients with versus without VFs (P = 0.07). Mortality was higher in patients with severe versus moderate and mild VFs (P = 0.04).

"Vertebral fractures are a marker of frailty, and for the first time we show that individuals who have such fractures appear to be at increased risk of severe COVID-19," a coauthor said in a statement. "A simple thoracic X-ray can detect these fractures and morphometric evaluation should be performed in COVID-19 patients at hospital admission."

Two authors disclosed financial ties to the pharmaceutical industry.

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