Management of osteoarthritis during COVID-19 pandemic

The pandemic spread of the new COVID-19 coronavirus infection in China first, and all over the world at present, has become a global health emergency due to the rapidly increasing number of affected patients. Currently, a clear relationship between COVID-19 infection incidence and/or complications due to chronic or occasional treatments for other pathologies is still not clear, albeit COVID-19 pandemic may condition the treatment strategy of complex disorders, as osteoarthritis (OA). Importantly, OA is the most common age-related joint disease affecting more than 80% of people older than the age of 55, an age burden also shared with the highest severity in COVID-19 patients. OA patients often show a large array of concomitant pathologies such as diabetes, inflammation and cardiovascular diseases that are again shared with COVID-19 patients and may therefore increase complications. Moreover, different OA treatments such as NSAIDs, paracetamol, corticosteroids, opioids or other molecules have a wide array of iatrogenic effects, potentially increasing COVID-19 secondary infection incidence or complications. In this review we critically analyse the evidences on either negative or positive effect of drugs commonly used to manage OA in this particular scenario. This would provide orthopaedic surgeons at first, and physicians, pharmacologists and clinicians at general, a comprehensive description about the safety of the current pharmacological approaches and a decision making tool to treat their OA patients as the coronavirus pandemic continues.