COVID-19 Research Paper Volume 12, Issue 20 pp 19923—19937

Influence of anti-osteoporosis treatments on the incidence of COVID-19 in patients with non-inflammatory rheumatic conditions

Josep Blanch-Rubió1,2, *, , Natalia Soldevila-Domenech3,7, *, , Laura Tío2, , Jone Llorente-Onaindia2, , Manuel Ciria-Recasens1,2, , Luciano Polino2, , Alba Gurt5, , Rafael de la Torre3,6,7, , Rafael Maldonado2,4, §, , Jordi Monfort1,2, §, , the Covidmar Study Group #, ,

  • 1 Rheumatology Service, Hospital del Mar, Passeig Marítim, Barcelona 08003 , Spain
  • 2 IMIM (Hospital del Mar Medical Research Institute), PRBB, Barcelona 08003, Spain
  • 3 Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, PRBB, Barcelona 08003, Spain
  • 4 Laboratory of Neuropharmacology, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, PRBB, Barcelona 08003, Spain
  • 5 CAP Vila Olímpica, Parc Sanitari Pere Virgili, Barcelona 08005, Spain
  • 6 Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid 28029, Spain
  • 7 Department of Experimental and Health Sciences, Universitat Pompeu Fabra, PRBB, Barcelona 08003, Spain
* Equal contribution
§ Equally supervised this work
# A list of authors and their affiliations appears in Acknowledgments in Collaborators section of PubMed.

Received: July 21, 2020       Accepted: September 9, 2020       Published: October 20, 2020
How to Cite

Copyright: © 2020 Blanch-Rubió et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Coronavirus disease 19 (COVID-19) is currently a global pandemic that affects patients with other pathologies. Here, we investigated the influence of treatments for osteoporosis and other non-inflammatory rheumatic conditions, such as osteoarthritis and fibromyalgia, on COVID-19 incidence. To this end, we conducted a cross-sectional study of 2,102 patients being treated at the Rheumatology Service of Hospital del Mar (Barcelona, Spain). In our cohort, COVID-19 cumulative incidence from March 1 to May 3, 2020 was compared to population estimates for the same city. We used Poisson regression models to determine the adjusted relative risk ratios for COVID-19 associated with different treatments and comorbidities. Denosumab, zoledronate and calcium were negatively associated with COVID-19 incidence. Some analgesics, particularly pregabalin and most of the studied antidepressants, were positively associated with COVID-19 incidence, whereas duloxetine presented a negative association. Oral bisphosphonates, vitamin D, thiazide diuretics, anti-hypertensive drugs and chronic non-steroidal anti-inflammatory drugs had no effect on COVID-19 incidence in the studied population. Our results provide novel evidence to support the maintenance of the main anti-osteoporosis treatments in COVID-19 patients, which may be of particular relevance to elderly patients affected by the SARS-CoV-2 pandemic.


ARBs: angiotensin II receptor blockers; ACE: angiotensin-converting-enzyme; CI: confidence interval; COVID-19: Coronavirus disease 19; CV: cardiovascular; NSAIDs: non-steroidal anti-inflammatory drugs; SERMs: selective estrogen receptor modulators; SSRIs: serotonin reuptake inhibitors.