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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Cytokines and Soluble Mediators in Immunity
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1493643

Effects of COVID-19 on bone fragility: a new perspective from osteoimmunological biomarkers

Provisionally accepted
Emanuela Galliera Emanuela Galliera 1,2,3*Luca Massaccesi Luca Massaccesi 2,4Laura Mangiavini Laura Mangiavini 3Elena De Vecchi Elena De Vecchi 3Francesca Villa Francesca Villa 3Massimiliano M. Corsi Romanelli Massimiliano M. Corsi Romanelli 2,5Giuseppe Peretti Giuseppe Peretti 2,3
  • 1 University of Milan, Milan, Italy
  • 2 Department of Biomedical Sciences for Health , Università degli Studi di Milano, Milan, Italy, Milan, Italy
  • 3 IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Lombardy, Italy
  • 4 Laboratorio sperimentale ricerche Biomarcatori Danno d'Organo, Istituto Auxologico Italiano IRCCS, Milan, Italy, Milan, Italy
  • 5 Department of Experimental and Clinical Pathology, IRCCS Istituto Auxologico Italiano, Italy, Milan, Italy

The final, formatted version of the article will be published soon.

    While there is an increasing understanding of COVID-19's effect on different organs, little is known about the effect of the disease on bone turnover and remodeling so far. Osteoimmunological biomarkers have been described as potential indicators of bone remodeling in inflammatory conditions, but their potential role in evaluating the effect of COVID-19 on bone fragility has not been explored so far. The present study aims to measure the osteoimmunological biomarkers in elderly patients undergoing orthopedic surgery, to evaluate the potential effect of COVID-19 on the bone response to the surgery. In our patients, the RANKL/OPG ratio indicated an increase of bone resorption in COVID-19-positive patients, confirming a strong diagnostic and prognostic value. RANKL/OPG displays a good correlation with the bone fragility maker FGF23, indicating that this parameter is a reliable maker of bone fragility in COVID-19 patients and could provide useful and comprehensive information about inflammation-induced bone loss. Consistently, the RANKL/OPG ratio showed a good correlation also with the two inflammatory markers IL-6 and sRAGE. Taken together these results indicate that the use of an osteoimmunological biomarker like the RANKL/OPG ratio could provide a significant improvement in the clinical evaluation of the COVID-19 effect on bone loss. This aspect is extremely important in elderly patients undergoing orthopedic surgery, which can manifest more severe effects of COVID-19 and present an increased level of age-induced bone fragility.

    Keywords: COVID-19, Osteoimmunological markers, Bone Remodeling, Bone fragility, Serum biomarkers

    Received: 09 Sep 2024; Accepted: 02 Oct 2024.

    Copyright: © 2024 Galliera, Massaccesi, Mangiavini, De Vecchi, Villa, Corsi Romanelli and Peretti. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Emanuela Galliera, University of Milan, Milan, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.