Wei Qiao, Hui En Lau, Huizhi Xie, Vincent Kwok-Man Poon, Chris Chung-Sing Chan,Hin Chu, Shuofeng Yuan, Terrence Tsz-Tai Yuen, Kenn Ka-Heng Chik, Jessica Oi-Ling Tsang, Chris Chun-Yiu Chan, Jian-Piao Cai, Cuiting Luo, Kwok-Yong Yuen, Kenneth Man-Chee Cheung, Jasper Fuk-Woo Chan & Kelvin Wai-Kwok Yeung

Abstract

Extrapulmonary complications of different organ systems have been increasingly recognized in patients with severe or chronic Coronavirus Disease 2019 (COVID-19). However, limited information on the skeletal complications of COVID-19 is known, even though inflammatory diseases of the respiratory tract have been known to perturb bone metabolism and cause pathological bone loss. In this study, we characterize the effects of severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) infection on bone metabolism in an established golden Syrian hamster model for COVID-19. SARS-CoV-2 causes significant multifocal loss of bone trabeculae in the long bones and lumbar vertebrae of all infected hamsters. Moreover, we show that the bone loss is associated with SARS-CoV-2-induced cytokine dysregulation, as the circulating pro-inflammatory cytokines not only upregulate osteoclastic differentiation
in bone tissues, but also trigger an amplified pro-inflammatory cascade in the skeletal tissues to augment their pro-osteoclastogenesis effect