Post-COVID-19 Bone Mineral Density and Its Association with Demographic and Clinical Characteristics: A Cross-sectional Study

Abstract

Background: Neuromuscular and rheumatologic complications following coronavirus disease (COVID-19) have been widely studied, but its impact on bone health remains unclear. Objectives: To determine the bone mineral density (BMD) and its correlation with demographic and clinical factors in post-COVID-19 patients. Methods: This cross-sectional study was conducted in Urmia between July and December 2023. A total of 164 post-COVID-19 patients were recruited through convenience sampling from the bone densitometry center at Imam Khomeini Hospital. Data were collected using a demographic questionnaire and a standardized clinical checklist. A validated checklist was employed, and all densitometry results were interpreted by a single pulmonary subspecialist to minimize bias. Statistical analysis was performed using SPSS v22.0, employing descriptive statistics, chi-square tests, ANOVA, and Tukey’s post-hoc test. Results: Most patients were women (89.2%), with a mean age of 58.9 ± 11.3 years and a mean Body Mass Index (BMI) of 29.5 ± 4.6 kg/m2. The majority (81.6%) were treated as outpatients; only 5.1% of hospitalized patients required ICU admission. Osteoporosis prevalence was 5.1% in the femoral neck, 29.7% in the lumbar spine, and 32.3% in the radius. No significant associations were found between BMD and corticosteroid therapy, hospitalization, ICU admission, comorbidities, or gender (all P > 0.05). However, patients with osteoporosis were significantly older (68.7 ± 8.7 years) and had a lower BMI (27.1 ± 4.6) compared to those with osteopenia or normal bone density. ANOVA confirmed significant differences in age (P < 0.001) and BMI (P = 0.011) among these groups, with post-hoc tests indicating that osteoporosis was associated with higher age and lower BMI. Conclusions: Older age and lower body weight were associated with a higher risk of osteoporosis among post-COVID-19 patients. Clinicians should monitor bone health in high-risk groups to prevent long-term complications. Future research should use larger samples, longer follow-up periods, and control for medication effects. This study did not receive any specific funding.