Tissue location of SARS-CoV-2 RNA: A focus on bone and implications for skeletal health

During the first SARS-CoV-2 pandemic spread, COVID-19 was characterized early as representing a multisystemic disease not only affecting the respiratory functions of patients but also with multiple possible negative consequences on several tissues and organs, including bone metabolism. The early seminal clinical data showing a higher rate of acute hypocalcemia, lower vitamin D levels, and prevalent skeletal complications in COVID-19 patients were subsequently confirmed in larger cohorts and also animal models, both during acute infection and disease recovery. These data highlighted a strict bidirectional influence between COVID-19 and bone health, with negative consequences on acute and postinfection outcomes as well as the skeletal metabolism. The aim of this chapter is to summarize the main findings published in these last 3years focused on basic and clinical relationships between SARS-CoV-2 infection and bone health.