SAT-789 Morphometric vertebral fractures at hospitalization associate with Long COVID occurrence

Abstract Disclosure: L. di Filippo: None. M. Doga: None. F. Mangini: None. L. Gifuni: None. S. Sahagun: None. P. Rovere Querini: None. C.J. Rosen: None. A. Giustina: None. Long COVID is a multisystemic syndrome leading to significant morbidity. To date, a comprehensive characterization of underlying risk factors is still being defined. Osteoporosis and vertebral fractures (VFs) were associated with worse acute COVID-19 and impaired respiratory recovery after hospitalization. Therefore, we aimed to assess the potential relationship between VFs and the occurrence of the Long COVID syndrome. Patients hospitalized for acute COVID-19 during the first pandemic wave from March to May 2020 and subsequently evaluated in our outpatient follow-up clinic 6-months after discharge were evaluated. We retrospectively included patients with available lateral chest X-rays performed at emergency department admission suitable for VFs assessments. We excluded patients with active neoplasia, and those managed at home or those hospitalized in ICU. Long COVID was diagnosed with a multidisciplinary evaluation on the basis of the National Institute for Health and Care Excellence guidelines. One-hundred sixty-two patients were included in the study. At least one VF was found in 42 patients at presentation (25.9%). Patients presenting with VFs were significantly older as compared to those without, there were more males, and these patients were more frequently affected by arterial hypertension, cardiovascular disease and CKD. No other statistical differences were found between patients with VFs and those without. Long COVID was diagnosed in 25 patients (15.4%). No statistically significant differences were found between patients with Long COVID and those without regarding age, gender, prevalence of comorbidities and in-hospital outcomes. However, patients presenting with Long COVID were characterized by a higher prevalence of VFs detected at admission as compared to those without (12/25 48% vs 30/137 22%, p=0.01). Forty-two patients presenting VFs at hospital admission were matched in a 1:1 ratio for age, sex, concomitant comorbidities, and disease severity with patients without VFs, and a total of 84 patients were finally analysed. Long COVID was present in 16 of them, and those presenting VFs at ED admission were characterized by a higher prevalence of Long COVID as compared to those without VFs (12/42 28.6% vs 4/42 9.5%, p=0.04). In multiple regression analysis including demographic characteristics, comorbidities, and presence of VFs, in our matched cohort, presence of VFs resulted as the only variable significantly and independently associated with the Long COVID occurrence (p=0.011, OR 3.41 CI 1.75-7.58). We observed that prevalent VFs detected at hospital admission were distinctive clinical features of patients presenting with Long COVID 6-months after discharge, independently from acute disease severity and other confounding factors. This highlights a potential detrimental association between skeletal fragility and the development of Long COVID. Presentation: Saturday, July 12, 2025