It is acknowledged that the COVID-19 pandemic has caused profound disruption to the delivery of healthcare services globally. This has affected the management of many long-term conditions including osteoporosis as resources are diverted to cover urgent care. Osteoporosis is a public health concern worldwide and treatment is required for the prevention of further bone loss, deterioration of skeletal micro-architecture, and fragility fractures. This review provides information on how the COVID-19 pandemic has impacted the diagnosis and management of osteoporosis. We also provide clinical recommendations on the adaptation of care pathways based on experience from five referral centres to ensure that patients with osteoporosis are still treated and to reduce the risk of fractures both for the individual patient and on a societal basis. We address the use of the FRAX tool for risk stratification and initiation of osteoporosis treatment and discuss the potential adaptations to treatment pathways in view of limitations on the availability of DXA. We focus on the issues surrounding initiation and maintenance of treatment for patients on parenteral therapies such as zoledronate, denosumab, teriparatide, and romosozumab during the pandemic. The design of these innovative care pathways for the management of patients with osteoporosis may also provide a platform for future improvement to osteoporosis services when routine clinical care resumes.

众所周知，COVID-19 大流行对全球医疗保健服务的提供造成了严重破坏。这影响了包括骨质疏松症在内的许多长期疾病的管理，因为资源被转用于紧急护理。骨质疏松症是世界范围内的公共卫生问题，需要治疗以预防进一步的骨质流失、骨骼微结构的恶化和脆性骨折。本综述提供了有关 COVID-19 大流行如何影响骨质疏松症诊断和管理的信息。我们还根据五个转诊中心的经验提供有关调整护理路径的临床建议，以确保骨质疏松症患者仍然得到治疗，并降低个体患者和社会基础上的骨折风险。我们解决了使用 FRAX 工具进行风险分层和开始骨质疏松症治疗的问题，并讨论了鉴于 DXA 可用性的限制对治疗途径的潜在适应。我们专注于在大流行期间围绕唑来膦酸、地诺单抗、特立帕肽和 romosozumab 等肠外治疗患者的治疗开始和维持问题。这些用于管理骨质疏松症患者的创新护理途径的设计也可能为未来恢复常规临床护理时改善骨质疏松症服务提供一个平台。我们专注于在大流行期间围绕唑来膦酸、地诺单抗、特立帕肽和 romosozumab 等肠外治疗患者的治疗开始和维持问题。这些用于管理骨质疏松症患者的创新护理途径的设计也可能为未来恢复常规临床护理时改善骨质疏松症服务提供一个平台。我们专注于在大流行期间围绕唑来膦酸、地诺单抗、特立帕肽和 romosozumab 等肠外治疗患者的治疗开始和维持问题。这些用于管理骨质疏松症患者的创新护理途径的设计也可能为未来恢复常规临床护理时改善骨质疏松症服务提供一个平台。