Objective: To investigate the effect of the COVID-19 pandemic on denosumab persistence. Methods: All patients who initiated denosumab treatment at our outpatient care (osteoporosis/endocrinology unit) between 2016-2019 were included and date of injections were recorded from case records. Persistence was analyzed regarding 2-y persistence and 1-y persistence. Persistence was defined as a maximum interval of either 1) 8 months (m) [6+2m], or 2) 9m [6+3m]. Results: In total 171 patients were included. Mean age was 74.3+10.2 y (range 35-93 y) and 87% were women. Age and gender distribution did not differ significantly between the year of denosumab initiation. The 2-y persistence rate (8-m interval permitted) was lower in patients starting denosumab 2019 than those starting 2016-1018, i.e., 69% vs. 83%, p=0.044. No significant difference was seen analyzing 1-y persistence in the same groups (87 vs. 91%, p=0.410). When using a more liberal persistence definition, i.e., 9+m interval permitted, no difference was seen between 2 y persistence, 77 vs. 83%, p=0.341. Conclusion: The present study indicates that a higher number of patients got their injection later than recommended during the pandemic, but despite high pressure on our healthcare system and health concerns in the general population, no significant influence on denosumab persistence using a more liberal interval allowance was seen in this outpatient osteoporosis group.