Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA.
Harvard Medical School, Boston, MA, USA.
Skeletal Radiol. 2021 Jun;50(6):1117-1123. doi: 10.1007/s00256-020-03656-w. Epub 2020 Oct 27.
Musculoskeletal pain is a debilitating problem treated with image-guided corticosteroid injections. During the COVID-19 pandemic, multiple societies issued caution statements because of the unknown effect of corticosteroids on the patient's immune system. The purpose is to determine if image-guided corticosteroid injections administered during the COVID-19 lockdown phase were associated with a higher infection rate compared to the general population.
In a prospective study, patients undergoing image-guided corticosteroid injections for pain management during the lockdown phase between April 15 and May 22, 2020, were enrolled. One month after the injection, patients were surveyed by telephone for any COVID-19-related symptoms, and the electronic medical record (EMR) was reviewed for symptoms and test results.
Seventy-one subjects were recruited, 31 (44%) females, 40 (56%) males, ages 58 ± 17 (20-92) years. Follow-up was available in 66 (93%) of subjects, 60 (91%) by phone survey and EMR, 6 (9%) by EMR only, 45 ± 22 (19-83) days after injection. One (1/66, 1.52%; 95% CI 0.04-8.2%) 25-year-old male subject developed symptomatic infection 19 days after a tibiotalar injection. The prevalence of COVID-19 cases in the state of Massachusetts was 0.91% (62,726/6,892,503) during the study period. There was no significant difference in the rate of occurrence of new cases of COVID-19 infection between the corticosteroid injection group and the general population (p = 0.44).
Image-guided corticosteroid injections for pain management performed during the lockdown phase of the COVID-19 pandemic were not associated with a higher infection rate compared to the general population.
肌肉骨骼疼痛是一种使人虚弱的问题，可通过影像学引导下的皮质类固醇注射来治疗。在 COVID-19 大流行期间，由于皮质类固醇对患者免疫系统的未知影响，多个学会发布了警告声明。本研究旨在确定与普通人群相比，在 COVID-19 封锁阶段进行影像学引导下皮质类固醇注射是否与更高的感染率相关。
在一项前瞻性研究中，招募了在 2020 年 4 月 15 日至 5 月 22 日封锁期间接受影像学引导下皮质类固醇注射以进行疼痛管理的患者。在注射后 1 个月，通过电话对患者进行任何 COVID-19 相关症状调查，并查阅电子病历（EMR）以了解症状和检查结果。
共招募了 71 名受试者，其中 31 名（44%）为女性，40 名（56%）为男性，年龄为 58 ± 17 岁（20-92 岁）。66 名（93%）受试者可获得随访结果，其中 60 名（91%）通过电话调查和 EMR，6 名（9%）仅通过 EMR，在注射后 45 ± 22 天（19-83 天）。1 名（1/66，1.52%；95%CI，0.04-8.2%）25 岁男性患者在距距下关节和跟骨注射后 19 天出现有症状感染。在研究期间，马萨诸塞州的 COVID-19 病例发生率为 0.91%（62,726/6,892,503）。皮质类固醇注射组与普通人群的 COVID-19 感染新发病例发生率无显著差异（p = 0.44）。
与普通人群相比，在 COVID-19 大流行封锁期间进行的影像学引导下皮质类固醇注射治疗疼痛并未导致更高的感染率。
