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Case Reports
. 2021 Jul 2;14(7):e242101.
doi: 10.1136/bcr-2021-242101.

Avascular necrosis as a part of 'long COVID-19'

Sanjay R Agarwala  1 , Mayank Vijayvargiya  2 , Prashant Pandey  2
Affiliations
Case Reports

Avascular necrosis as a part of 'long COVID-19'

Sanjay R Agarwala et al. BMJ Case Rep. .

Abstract

'Long COVID-19' can affect different body systems. At present, avascular necrosis (AVN) as a sequalae of 'long COVID-19' has yet not been documented. By large-scale use of life-saving corticosteroids in COVID-19 cases, we anticipate that there will be a resurgence of AVN cases. We report a series of three cases in which patients developed AVN of the femoral head after being treated for COVID-19 infection. The mean dose of prednisolone used in these cases was 758 mg (400-1250 mg), which is less than the mean cumulative dose of around 2000 mg steroid, documented in the literature as causative for AVN. Patients were symptomatic and developed early AVN presentation at a mean of 58 days after COVID-19 diagnosis as compared with the literature which shows that it generally takes 6 months to 1 year to develop AVN post steroid exposure.

Keywords: COVID-19; drugs: musculoskeletal and joint diseases; groin pain; musculoskeletal and joint disorders; unwanted effects/adverse reactions.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
MRI and anteroposterior radiograph of the 36-year-old male patient confirming bilateral avascular necrosis of the femoral head (Ficat-Arlet stage II).
Figure 2
Figure 2
MRI and anteroposterior radiograph of the 39-year-old male patient confirming bilateral avascular necrosis of the femoral head (Ficat-Arlet stage II).
Figure 3
Figure 3
MRI and anteroposterior radiograph of the 37-year-old male patient confirming avascular necrosis of the femoral head of the bilateral hip (Ficat-Arlet stage II).
See this image and copyright information in PMC

References

    1. WHO coronavirus disease (COVID-19) Dashboard.
    1. Leung TYM, Chan AYL, Chan EW, et al. Short- and potential long-term adverse health outcomes of COVID-19: a rapid review. Emerg Microbes Infect 2020;9:2190–9. 10.1080/22221751.2020.1825914 - DOI - PMC - PubMed
    1. Mahase E. Covid-19: What do we know about "long covid"? BMJ 2020;370:m2815. 10.1136/bmj.m2815 - DOI - PubMed
    1. Ferrari F, Martins VM, Fuchs FD. Renin-Angiotensin-Aldosterone system inhibitors in COVID-19: a review. Clinics 2021;9:e2342:76. 10.6061/clinics/2021/e2342 - DOI - PMC - PubMed
    1. Ip A, Ahn J, Zhou Y, et al. Hydroxychloroquine in the treatment of outpatients with mildly symptomatic COVID-19: a multi-center observational study. BMC Infect Dis 2021;21:72. 10.1186/s12879-021-05773-w - DOI - PMC - PubMed

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