ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of calcium metabolic disorders and osteoporosis.
ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of calcium metabolic disorders and osteoporosis.
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DOI：
10.1530/eje-20-0385
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发表时间：
2020-08
影响因子：
5.8
通讯作者：
Hassan-Smith Z
中科院分区：
文献类型：
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作者：
Gittoes NJ;Criseno S;Appelman-Dijkstra NM;Bollerslev J;Canalis E;Rejnmark L;Hassan-Smith Z
内分泌学家不得不对服务进行快速调整，以便资源可以集中在新冠肺炎应对上，以帮助防止病毒传播。在这里，我们对常见的钙代谢问题和骨质疏松症的管理提供务实的建议。应该推迟非紧急的可选预约，推广远程会诊和数字健康解决方案。患者应该被授权安全地自我管理自己的病情。患者、他们的照顾者和医疗保健提供者应该被引导到有保证的国内或国际在线资源和特定的患者群体。对于急性医院环境中的患者，应遵循现有的高、低钙血症处理的紧急指南。概述了骨质疏松症的治疗方法。在大流行期间，静脉注射唑来膦酸可能会推迟6-9个月。服用地诺单抗、特立帕帝和阿巴罗帕帝的患者应继续计划治疗。在Teriparatide或abaloparatide出现供应问题的情况下，短期内暂停这种治疗可能相对无害，而推迟denosumab可能会立即导致骨折风险增加。这场大流行的挑战将成为我们在代谢性骨骼和矿物质疾病管理方面进行创新的催化剂，以确保最佳利用资源和医疗系统在其后果后的弹性。
Endocrinologists have had to make rapid changes to services so that resources can be focused on the COVID-19 response to help prevent spread of the virus. Herein we provide pragmatic advice on the management of commonly encountered calcium metabolic problems and osteoporosis. Non-urgent elective appointments should be postponed, and remote consultations and digital health solutions promoted. Patients should be empowered to self-manage their conditions safely. Patients, their caregivers and healthcare providers should be directed to assured national or international online resources and specific patient groups. For patients in acute hospital settings, existing emergency guidance on the management of hyper- and hypo-calcaemia should be followed. An approach to osteoporosis management is outlined. IV zoledronic acid infusions can be delayed for 6–9 months during the pandemic. Patients established on denosumab, teriparatide and abaloparatide should continue planned therapy. In the event of supply issues with teriparatide or abaloparatide, pausing this treatment in the short term is likely to be relatively harmless, whereas delaying denosumab may cause an immediate increased risk of fracture. The challenge of this pandemic will act as a catalyst to innovate within our management of metabolic bone and mineral disorders to ensure best use of resources and resilience of healthcare systems in its aftermath.