Orthopaedics, PD Hinduja National Hospital, Mumbai, Maharashtra, India
Orthopaedics, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India.
BMJ Case Rep. 2021 Jul 2;14(7):e242101. doi: 10.1136/bcr-2021-242101.
'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.
“长新冠”可影响不同的身体系统。目前,尚未有文献记载股骨头无菌性坏死(AVN)是“长新冠”的后遗症。由于在 COVID-19 病例中大剂量使用救命的皮质类固醇,我们预计 AVN 病例将会再次出现。我们报告了三例患者,他们在 COVID-19 感染治疗后出现股骨头 AVN。这些病例中使用的泼尼松龙平均剂量为 758 毫克(400-1250 毫克),低于文献中记载的导致 AVN 的约 2000 毫克类固醇的平均累积剂量。与文献表明的在类固醇暴露后一般需要 6 个月至 1 年才能发生 AVN 相比,这些患者出现症状且在 COVID-19 诊断后平均 58 天即出现早期 AVN 表现。