(HealthDay)—Vertebral fractures (VFs) are a clinical marker of fragility and poor prognosis in patients with COVID-19, according to a study published online Oct. 21 in the Journal of Clinical Endocrinology & Metabolism.

Luigi di Filippo, M.D., from the Vita-Salute San Raffaele University in Milan, and colleagues examined the prevalence and clinical impact of VFs in COVID-19 in a retrospective cohort study. One hundred fourteen COVID-19 for whom lateral chest X-rays were available were included; a semi-quantitative evaluation of vertebral shape on chest X-ray was used to detect VFs.

The researchers detected thoracic VFs in 41 patients (36 percent). Patients with VFs were older and more frequently had hypertension and . Hospitalization occurred in 88 versus 74 percent of patients with versus without VFs (P = 0.08). Compared with those without VFs, patients with VFs required noninvasive mechanical ventilation more frequently (P = 0.02). Mortality was 22 versus 10 percent in patients with versus without VFs (P = 0.07). Mortality was higher in patients with severe versus moderate and mild VFs (P = 0.04).

"Vertebral fractures are a marker of frailty, and for the first time we show that individuals who have such fractures appear to be at increased risk of severe COVID-19," a coauthor said in a statement. "A simple thoracic X-ray can detect these fractures and morphometric evaluation should be performed in COVID-19 patients at hospital admission."

Two authors disclosed financial ties to the pharmaceutical industry.