Bone Death - A Newly Emerging Post-Covid Complication

Avascular necrosis or bone death is emerging as a new post-covid complication. Three confirmed cases of bone death among covid survivors have been reported in Mumbai.

Highlights :

Three confirmed cases of bone death have been reported in Mumbai
Steroid therapy for COVID-19 could be the major cause of avascular necrosis or bone death
Prompt diagnosis can help manage the disease without the need for surgery

Avascular necrosis (AVN), a bone disease, is emerging as a new post-covid complication after the series of life-threatening fungal infections. Experts opine that this could be an issue of concern if more cases continue to come up in the upcoming months.

Doctors advise COVID survivors with hip or thigh pain to consult a physician for earlier diagnosis, as the cases related to avascular necrosis seem to pose an additional burden amidst the healthcare threats we are already facing.

Post-COVID Syndrome
Post-COVID complications are the conditions that develop weeks after recovering from COVID-19

‘Three covid survivors under the age of forty reported symptoms of bone death to date. Large-scale use of steroid medications for covid treatment could be the primary cause of this disease.’
Read More..

Incidence of Bone Death among COVID Survivors

Three confirmed cases of avascular necrosis among covid survivors have been reported from Mumbai. All three subjects are below the age of 40, and they developed this complication around two months after the treatment for COVID-19.

"These patients developed pain in their femur bone (the highest part of the thigh bone) and, since they were doctors, they recognized the symptoms and rushed for treatment," said Dr. Sanjay Agarwala, medical director of Hinduja Hospital, Mahim, as per a report of Times of India.

A high dose of corticosteroids is already known to cause avascular necrosis as it reduces blood flow in the body by increasing lipid levels in the blood. The doctor, in his research paper published in the journal BMJ Case Studies "Avascular necrosis as a part of long Covid-19", highlighted "large-scale use of life-saving corticosteroids" used in the treatment of covid-19 could be the major cause behind this complication.

Green Fungus or Aspergillosis and COVID-19 Infection
Green fungus or Aspergillosis is caused by a common mold, which exists both indoors and outdoors. Every day, people inhale Aspergillus spores, but it isn't harmful. However, it affects people who have a weak immune system. If the infection is left untreated, it can cause pneumonia.

What actually is AVN or Bone Death, and What are its Symptoms?

Avascular necrosis or osteonecrosis refers to the death of bone tissue. The reason behind this condition could be the loss of blood supply to the bones, be it temporary or permanent. The disease can occur in any bone but mainly occurs in the bones of the thigh, hip, and joint regions.

In general, patients who developed osteonecrosis do not show symptoms at early stages. When the condition worsens, pain around the hip, thigh, shoulder, feet, knee, groin, and buttock regions can be experienced. Although anyone can experience it, people in the 30 to 50 age group pose a higher risk than others.

Steroids Could Decrease COVID-19 Complications in Kids
Corticosteroids may be an effective treatment for children who develop multi-system inflammatory syndrome in children (MIS-C) after COVID-19.

Is There a Cure for AVN?

For prevention, cholesterol-lowering drugs and blood thinners are used to eliminate the risks of blood vessel blockages and blood clots, respectively.

Medications like non-steroidal anti-inflammatory drugs help reduce pain. Drugs for osteoporosis might dampen the progression of the disease. Physiotherapy is considered a treatment of choice as it helps maintain the range of motion in joints. Advanced therapies like electrical stimulation or surgery might be recommended for some critical cases.

Reference:

Avascular necrosis - (https://www.mayoclinic.org/diseases-conditions/avascular-necrosis/diagnosis-treatment/drc-20369863)

Source-Medindia

COVID-19- Is Steroid Treatment Beneficial?
Commonly used steroid, dexamethasone, against COVID-19, is only beneficial if the patient is suffering from widespread inflammation due to the infection. When used under such circumstances, steroids reduce the risk of going on mechanical ventilation or death.