Azwan Aziz Mohamad, Abu Hanifah Redzal, Mohd Nahar Azmi Mohamed
Sports Medicine Department, University Malaya Medical Centre, Kuala Lumpur, Malaysia.
Sports Medicine Unit, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia.
Adv Orthop. 2021 Mar 27;2021:8863210. doi: 10.1155/2021/8863210. eCollection 2021.
Musculoskeletal corticosteroid injection is commonly used as an adjunct to help patients in pain management. In this current COVID-19 pandemic, many clinicians would differ from this treatment as steroid is considered an immunosuppressive drug and could risk the patient of developing severe adverse effects if contracting COVID-19. This is a retrospective study based in Sabah, Malaysia, examining the prevalence of COVID-19 infection following musculoskeletal corticosteroid injection from 1 December 2019 until 30 June 2020 in the sports medicine clinic and the orthopedic clinic. Patients who received musculoskeletal corticosteroid injection were called by telephone and asked about visits to the emergency department or government health clinic for influenza-like illness symptoms or severe acute respiratory infection that would require screening of COVID-19. Thirty-five patients who responded to the call were included, with mean ages of 47.9 years ± 15.1. 52% were male respondents, while 48% were female. 25% of them were diabetics, and 2.9% of them had a history of lymphoproliferative disorders. The mean pain score before injection was 6.74 ± 1.03 and after injection pain was 2.27 ± 1.63. In this study, there were 11.4% ( = 4) with minor complications of steroid injection, that is, skin discoloration. Nonetheless, there were no severe complications due to corticosteroids reported. There were no reported cases of COVID-19 among the respondents following corticosteroid injection. Musculoskeletal pain would affect a person's well-being and activities; thus, its management requires that careful consideration with risk-benefit analysis be made before administering musculoskeletal corticosteroid injection during COVID-19 pandemic.
肌肉骨骼系统皮质类固醇注射通常作为辅助手段，帮助患者进行疼痛管理。在当前的新冠疫情中，许多临床医生对这种治疗方法存在不同看法，因为类固醇被认为是一种免疫抑制药物，如果感染新冠病毒，可能会使患者面临出现严重不良反应的风险。这是一项基于马来西亚沙巴州的回顾性研究，调查了2019年12月1日至2020年6月30日期间，在运动医学诊所和骨科诊所接受肌肉骨骼系统皮质类固醇注射后感染新冠病毒的情况。通过电话联系接受过肌肉骨骼系统皮质类固醇注射的患者，询问他们是否因流感样疾病症状或需要进行新冠病毒筛查的严重急性呼吸道感染而去急诊室或政府健康诊所就诊。35名回复电话的患者被纳入研究，平均年龄为47.9岁±15.1岁。52%为男性受访者，48%为女性。其中25%为糖尿病患者，2.9%有淋巴增殖性疾病史。注射前的平均疼痛评分为6.74±1.03，注射后的疼痛评分为2.27±1.63。在这项研究中，有11.4%（n = 4）的患者出现了类固醇注射的轻微并发症，即皮肤变色。尽管如此，没有报告因皮质类固醇导致的严重并发症。在接受皮质类固醇注射的受访者中，没有报告新冠病毒感染病例。肌肉骨骼疼痛会影响一个人的幸福感和活动能力；因此，在新冠疫情期间进行肌肉骨骼系统皮质类固醇注射之前，需要对其进行仔细考虑并进行风险效益分析。
