Perturbation Patterns of Bone Metabolism Secondary to COVID-19 Among Nigerian Healthcare Workers

Friday Enwumelu Aaron; Collins Amadi; Stephenson Lawson; Ezra Agbo; Johnbosco Chidozie Okafor

doi:doi:10.11648/j.cmr.20241305.12

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| Peer-Reviewed

Perturbation Patterns of Bone Metabolism Secondary to COVID-19 Among Nigerian Healthcare Workers

Friday Enwumelu Aaron

, Collins Amadi^*

, Stephenson Lawson

, Ezra Agbo

, Johnbosco Chidozie Okafor

Published in Clinical Medicine Research (Volume 13, Issue 5)

Received: 14 August 2024 Accepted: 10 September 2024 Published: 29 October 2024

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Abstract

Background: Severe acute respiratory coronavirus-2 (SARS-CoV-2), the etiologic agent of coronavirus disease of 2019 (COVID-19) is known to affect several organ systems. However, the disease’s influence on bone metabolism is poorly characterized especially among native Nigerians. Consequently, the current study explored the effect of the disease on bone metabolism among Nigerian healthcare workers (HCWs). Methods: This was a prospective longitudinal study conducted in the Department of Chemical Pathology of the Rivers State University Teaching Hospital among unvaccinated HCWs in Rivers State, Southern Nigeria. Eligible HCWs (n=96) were followed up from when they unwittingly had contact with SARS-CoV-2 infected/COVID-19 patients until they developed symptomatic RT-PCR-confirmed COVID-19. Demographic, anthropometric, clinical, and laboratory data were obtained before and at diagnosis/confirmation of COVID-19 among the eligible HCWs. Statistical analysis was done using descriptive/inferential statistics at a p-value of <0.05. Results: At COVID-19 diagnosis, the HCWs had increased levels of inflammatory markers (procalcitonin, C-reactive protein, and D-dimer), raised bone resorption marker (s-CTX), but reduced bone formation marker (s-PINP) compared to the pre-COVID-19 parameters (p<0.001). These cardinal biochemical findings were more prominent among those with severe disease variant than those with non-severe disease variant (p<0.001). In addition, a negative correlation pattern was observed between these inflammatory markers and the bone formation marker, however, a positive correlation was observed between the inflammatory markers and the bone resorption marker (p<0.001). Conclusion: The current finding indicates perturbation of bone metabolism, associated with increased bone resorption pattern, secondary to COVID-19 among the studied population. Hence, it is highly recommended that the evaluation of bone metabolism status be incorporated into the management protocols for COVID-19.

Published in	Clinical Medicine Research (Volume 13, Issue 5)
DOI	10.11648/j.cmr.20241305.12
Page(s)	60-67
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

SARS-CoV-2, COVID-19, Bone Markers, PINP, CTX

References

[1]	Feehan J, Apostolopoulos V. Is COVID-19 the worst pandemic? Maturitas. 2021; 149: 56-58.
[2]	Al-Harrasi A, Bhatia S, Behl T, Kaushik D, Ahmed MM, Anwer K. Effect of COVID-19 on Different Organ Systems. In Role of Essential Oils in the Management of COVID-19 2022 (pp. 109-131). CRC Press.
[3]	Birman D. Investigation of the Effects of Covid-19 on Different Organs of the Body. Eurasian J Chem Med Petro Res. 2023; 2(1): 24-36.
[4]	Golzardi M, Hromić-Jahjefendić A, Šutković J, Aydin O, Ünal-Aydın P, Bećirević T, et al. The Aftermath of COVID-19: Exploring the Long-Term Effects on Organ Systems. Biomedicines. 2024; 12(4): 913.
[5]	Disser NP, De Micheli AJ, Schonk MM, Konnaris MA, Piacentini AN, Edon DL, et al. Musculoskeletal consequences of COVID-19. JBJS. 2020; 102(14): 1197-204.
[6]	Awosanya OD, Dadwal UC, Imel EA, Yu Q, Kacena MA. The Impacts of COVID-19 on Musculoskeletal Health. Curr Osteoporos Rep. 2022; 20(4): 213-225.
[7]	Hu CL, Zheng MJ, He XX, Liu DC, Jin ZQ, Xu WH, et al. COVID-19 and bone health. Eur Rev Med Pharmacol Sci. 2023; 27(7): 3191-3200.
[8]	Naing L, Winn T, Rusli BN. Practical issues in calculating the sample size for prevalence studies. Arch Orofac Sci. 2006; 1: 9–14.
[9]	Nas SF, Ali M, Azu LM, Abdallah MS, Yusuf SF. Epidemiology of novel COVID-19 in Nigeria. Microb Infect Dis 2020; 1(2): 49-56.
[10]	Nigerian Centre for Disease Control (NCDC) National Interim Guidelines for Clinical Management of COVID-19. Accessed 25th December 2022.
[11]	Li T, Wang L, Wang H, Gao Y, Hu X, Li X, et al. Characteristics of laboratory indexes in COVID-19 patients with non-severe symptoms in Hefei City, China: diagnostic value in organ injuries. Eur J Clin Microbiol Infect Dis. 2020; 39: 2447-55.
[12]	Kerschan-Schindl K, Dovjak P, Butylina M, Rainer A, Mayr B, Röggla V, Haslacher H, Weber M, Jordakieva G, Pietschmann P. Moderate COVID-19 disease is associated with reduced bone turnover. J Bone Miner Res. 2023; 38(7): 943-950.
[13]	Arrieta F, Martinez-Vaello V, Bengoa N, Rosillo M, de Pablo A, Voguel C, et al. Stress Hyperglycemia and Osteocalcin in COVID-19 Critically Ill Patients on Artificial Nutrition. Nutrients. 2021 Aug 28; 13(9): 3010.
[14]	Qiao W, Lau HE, Xie H, Poon VK, Chan CC, Chu H, et al. SARS-CoV-2 infection induces inflammatory bone loss in golden Syrian hamsters. Nat Commun. 2022; 13(1): 2539.
[15]	Gul MA, Kurt N, Ozgeris FB, Yuce N, Kocak OF, Parlak E. C-terminal cross-linking telopeptide levels in COVID-19 patients: A prospective case-control study [published online as ahead of print on March 21, 2024]. Adv Clin Exp Med. 2025. https://doi.org/10.17219/acem/185254
[16]	Epsley S, Tadros S, Farid A, Kargilis D, Mehta S, Rajapakse CS. The Effect of Inflammation on Bone. Front Physiol. 2021; 11: 511799. https://doi.org/10.3389/fphys.2020.511799
[17]	Terkawi MA, Matsumae G, Shimizu T, Takahashi D, Kadoya K, Iwasaki N. Interplay between Inflammation and Pathological Bone Resorption: Insights into Recent Mechanisms and Pathways in Related Diseases for Future Perspectives. Int J Mol Sci. 2022; 23(3): 1786. https://doi.org/10.3390/ijms23031786
[18]	Sapra L, Saini C, Garg B, Gupta R, Verma B, Mishra PK, Srivastava RK. Long-term implications of COVID-19 on bone health: pathophysiology and therapeutics. Inflamm Res. 2022; 71(9): 1025-1040. https://doi.org/10.1007/s00011-022-01616-9
[19]	Mi B, Xiong Y, Zhang C, Zhou W, Chen L, Cao F, et al. SARS-CoV-2-induced overexpression of miR-4485 suppresses osteogenic differentiation and impairs fracture healing. Intern J Biol Sci. 2021; 17: 1277–1288. https://doi.org/10.7150/ijbs.56657

Cite This Article

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APA Style

Aaron, F. E., Amadi, C., Lawson, S., Agbo, E., Okafor, J. C. (2024). Perturbation Patterns of Bone Metabolism Secondary to COVID-19 Among Nigerian Healthcare Workers. Clinical Medicine Research, 13(5), 60-67. https://doi.org/10.11648/j.cmr.20241305.12

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ACS Style

Aaron, F. E.; Amadi, C.; Lawson, S.; Agbo, E.; Okafor, J. C. Perturbation Patterns of Bone Metabolism Secondary to COVID-19 Among Nigerian Healthcare Workers. Clin. Med. Res. 2024, 13(5), 60-67. doi: 10.11648/j.cmr.20241305.12

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AMA Style

Aaron FE, Amadi C, Lawson S, Agbo E, Okafor JC. Perturbation Patterns of Bone Metabolism Secondary to COVID-19 Among Nigerian Healthcare Workers. Clin Med Res. 2024;13(5):60-67. doi: 10.11648/j.cmr.20241305.12

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@article{10.11648/j.cmr.20241305.12,
  author = {Friday Enwumelu Aaron and Collins Amadi and Stephenson Lawson and Ezra Agbo and Johnbosco Chidozie Okafor},
  title = {Perturbation Patterns of Bone Metabolism Secondary to COVID-19 Among Nigerian Healthcare Workers
},
  journal = {Clinical Medicine Research},
  volume = {13},
  number = {5},
  pages = {60-67},
  doi = {10.11648/j.cmr.20241305.12},
  url = {https://doi.org/10.11648/j.cmr.20241305.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20241305.12},
  abstract = {Background: Severe acute respiratory coronavirus-2 (SARS-CoV-2), the etiologic agent of coronavirus disease of 2019 (COVID-19) is known to affect several organ systems. However, the disease’s influence on bone metabolism is poorly characterized especially among native Nigerians. Consequently, the current study explored the effect of the disease on bone metabolism among Nigerian healthcare workers (HCWs). Methods: This was a prospective longitudinal study conducted in the Department of Chemical Pathology of the Rivers State University Teaching Hospital among unvaccinated HCWs in Rivers State, Southern Nigeria. Eligible HCWs (n=96) were followed up from when they unwittingly had contact with SARS-CoV-2 infected/COVID-19 patients until they developed symptomatic RT-PCR-confirmed COVID-19. Demographic, anthropometric, clinical, and laboratory data were obtained before and at diagnosis/confirmation of COVID-19 among the eligible HCWs. Statistical analysis was done using descriptive/inferential statistics at a p-value of Results: At COVID-19 diagnosis, the HCWs had increased levels of inflammatory markers (procalcitonin, C-reactive protein, and D-dimer), raised bone resorption marker (s-CTX), but reduced bone formation marker (s-PINP) compared to the pre-COVID-19 parameters (pConclusion: The current finding indicates perturbation of bone metabolism, associated with increased bone resorption pattern, secondary to COVID-19 among the studied population. Hence, it is highly recommended that the evaluation of bone metabolism status be incorporated into the management protocols for COVID-19.
},
 year = {2024}
}

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TY  - JOUR
T1  - Perturbation Patterns of Bone Metabolism Secondary to COVID-19 Among Nigerian Healthcare Workers

AU  - Friday Enwumelu Aaron
AU  - Collins Amadi
AU  - Stephenson Lawson
AU  - Ezra Agbo
AU  - Johnbosco Chidozie Okafor
Y1  - 2024/10/29
PY  - 2024
N1  - https://doi.org/10.11648/j.cmr.20241305.12
DO  - 10.11648/j.cmr.20241305.12
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 60
EP  - 67
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20241305.12
AB  - Background: Severe acute respiratory coronavirus-2 (SARS-CoV-2), the etiologic agent of coronavirus disease of 2019 (COVID-19) is known to affect several organ systems. However, the disease’s influence on bone metabolism is poorly characterized especially among native Nigerians. Consequently, the current study explored the effect of the disease on bone metabolism among Nigerian healthcare workers (HCWs). Methods: This was a prospective longitudinal study conducted in the Department of Chemical Pathology of the Rivers State University Teaching Hospital among unvaccinated HCWs in Rivers State, Southern Nigeria. Eligible HCWs (n=96) were followed up from when they unwittingly had contact with SARS-CoV-2 infected/COVID-19 patients until they developed symptomatic RT-PCR-confirmed COVID-19. Demographic, anthropometric, clinical, and laboratory data were obtained before and at diagnosis/confirmation of COVID-19 among the eligible HCWs. Statistical analysis was done using descriptive/inferential statistics at a p-value of Results: At COVID-19 diagnosis, the HCWs had increased levels of inflammatory markers (procalcitonin, C-reactive protein, and D-dimer), raised bone resorption marker (s-CTX), but reduced bone formation marker (s-PINP) compared to the pre-COVID-19 parameters (pConclusion: The current finding indicates perturbation of bone metabolism, associated with increased bone resorption pattern, secondary to COVID-19 among the studied population. Hence, it is highly recommended that the evaluation of bone metabolism status be incorporated into the management protocols for COVID-19.

VL  - 13
IS  - 5
ER  -

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Author Information

Friday Enwumelu Aaron

Department of Surgery, Rivers State University Teaching Hospital, Port Harcourt, Nigeria

Contact Email

http://orcid.org/0009-0005-8371-4213
Collins Amadi

Department of Chemical Pathology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria; Department of Chemical Pathology, PAMO University of Medical Sciences, Port Harcourt, Nigeria

Contact Email

http://orcid.org/0000-0002-5824-9496
Stephenson Lawson

Department of Medical Microbiology & Parasitology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria; Department of Medical Microbiology/Parasitology, PAMO University of Medical Sciences, Port Harcourt, Nigeria; Eleme COVID-19 Treatment Center, Port Harcourt, Nigeria

Contact Email

http://orcid.org/0000-0001-7984-334X
Ezra Agbo

Department of Chemical Pathology, Federal Medical Center, Abuja, Nigeria

Contact Email

http://orcid.org/0009-0001-7923-7312
Johnbosco Chidozie Okafor

Department of Chemical Pathology, University of Uyo Teaching Hospital, Uyo, Nigeria

Contact Email

http://orcid.org/0000-0002-5201-2295

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Plain Text BibTeX RIS

APA Style

Aaron, F. E., Amadi, C., Lawson, S., Agbo, E., Okafor, J. C. (2024). Perturbation Patterns of Bone Metabolism Secondary to COVID-19 Among Nigerian Healthcare Workers. Clinical Medicine Research, 13(5), 60-67. https://doi.org/10.11648/j.cmr.20241305.12

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ACS Style

Aaron, F. E.; Amadi, C.; Lawson, S.; Agbo, E.; Okafor, J. C. Perturbation Patterns of Bone Metabolism Secondary to COVID-19 Among Nigerian Healthcare Workers. Clin. Med. Res. 2024, 13(5), 60-67. doi: 10.11648/j.cmr.20241305.12

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AMA Style

Aaron FE, Amadi C, Lawson S, Agbo E, Okafor JC. Perturbation Patterns of Bone Metabolism Secondary to COVID-19 Among Nigerian Healthcare Workers. Clin Med Res. 2024;13(5):60-67. doi: 10.11648/j.cmr.20241305.12

Copy | Download

@article{10.11648/j.cmr.20241305.12,
  author = {Friday Enwumelu Aaron and Collins Amadi and Stephenson Lawson and Ezra Agbo and Johnbosco Chidozie Okafor},
  title = {Perturbation Patterns of Bone Metabolism Secondary to COVID-19 Among Nigerian Healthcare Workers
},
  journal = {Clinical Medicine Research},
  volume = {13},
  number = {5},
  pages = {60-67},
  doi = {10.11648/j.cmr.20241305.12},
  url = {https://doi.org/10.11648/j.cmr.20241305.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20241305.12},
  abstract = {Background: Severe acute respiratory coronavirus-2 (SARS-CoV-2), the etiologic agent of coronavirus disease of 2019 (COVID-19) is known to affect several organ systems. However, the disease’s influence on bone metabolism is poorly characterized especially among native Nigerians. Consequently, the current study explored the effect of the disease on bone metabolism among Nigerian healthcare workers (HCWs). Methods: This was a prospective longitudinal study conducted in the Department of Chemical Pathology of the Rivers State University Teaching Hospital among unvaccinated HCWs in Rivers State, Southern Nigeria. Eligible HCWs (n=96) were followed up from when they unwittingly had contact with SARS-CoV-2 infected/COVID-19 patients until they developed symptomatic RT-PCR-confirmed COVID-19. Demographic, anthropometric, clinical, and laboratory data were obtained before and at diagnosis/confirmation of COVID-19 among the eligible HCWs. Statistical analysis was done using descriptive/inferential statistics at a p-value of Results: At COVID-19 diagnosis, the HCWs had increased levels of inflammatory markers (procalcitonin, C-reactive protein, and D-dimer), raised bone resorption marker (s-CTX), but reduced bone formation marker (s-PINP) compared to the pre-COVID-19 parameters (pConclusion: The current finding indicates perturbation of bone metabolism, associated with increased bone resorption pattern, secondary to COVID-19 among the studied population. Hence, it is highly recommended that the evaluation of bone metabolism status be incorporated into the management protocols for COVID-19.
},
 year = {2024}
}

Copy | Download

TY  - JOUR
T1  - Perturbation Patterns of Bone Metabolism Secondary to COVID-19 Among Nigerian Healthcare Workers

AU  - Friday Enwumelu Aaron
AU  - Collins Amadi
AU  - Stephenson Lawson
AU  - Ezra Agbo
AU  - Johnbosco Chidozie Okafor
Y1  - 2024/10/29
PY  - 2024
N1  - https://doi.org/10.11648/j.cmr.20241305.12
DO  - 10.11648/j.cmr.20241305.12
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 60
EP  - 67
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20241305.12
AB  - Background: Severe acute respiratory coronavirus-2 (SARS-CoV-2), the etiologic agent of coronavirus disease of 2019 (COVID-19) is known to affect several organ systems. However, the disease’s influence on bone metabolism is poorly characterized especially among native Nigerians. Consequently, the current study explored the effect of the disease on bone metabolism among Nigerian healthcare workers (HCWs). Methods: This was a prospective longitudinal study conducted in the Department of Chemical Pathology of the Rivers State University Teaching Hospital among unvaccinated HCWs in Rivers State, Southern Nigeria. Eligible HCWs (n=96) were followed up from when they unwittingly had contact with SARS-CoV-2 infected/COVID-19 patients until they developed symptomatic RT-PCR-confirmed COVID-19. Demographic, anthropometric, clinical, and laboratory data were obtained before and at diagnosis/confirmation of COVID-19 among the eligible HCWs. Statistical analysis was done using descriptive/inferential statistics at a p-value of Results: At COVID-19 diagnosis, the HCWs had increased levels of inflammatory markers (procalcitonin, C-reactive protein, and D-dimer), raised bone resorption marker (s-CTX), but reduced bone formation marker (s-PINP) compared to the pre-COVID-19 parameters (pConclusion: The current finding indicates perturbation of bone metabolism, associated with increased bone resorption pattern, secondary to COVID-19 among the studied population. Hence, it is highly recommended that the evaluation of bone metabolism status be incorporated into the management protocols for COVID-19.

VL  - 13
IS  - 5
ER  -

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