Sakellariou Evangelos, Argyropoulou Evangelia, Karampinas Panagiotis, Galanis Athanasios, Varsamos Iordanis, Giannatos Vasileios, Vasiliadis Elias, Kaspiris Angelos, Vlamis John, Pneumaticos Spiros
Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, 14561 Athens, Greece.
Department of Orthopaedics and Traumatology, University General Hospital of Patras, 26504 Patras, Greece.
Diagnostics (Basel). 2024 Jan 24;14(3):247. doi: 10.3390/diagnostics14030247.
The COVID-19 pandemic has presented numerous challenges to the global healthcare system and emerging evidence suggests a potential link between COVID-19 treatment, specifically steroid therapy, and the development of avascular necrosis (AVN) of the hip. This review aims to provide a comprehensive overview of recent studies and case reports investigating the relationship between COVID-19, corticosteroid therapy, and the development of AVN. Understanding the nuances of AVN in the context of COVID-19 is crucial for healthcare professionals to navigate treatment decisions and mitigate potential complications.
The Preferred Reporting Items for Systematic Reviews and a Meta-Analysis (PRISMA) were used in the systematic review until 1 September 2023. The full texts of the remaining twenty-three ( = 23) articles were independently reviewed by the authors of this review.
The association between steroid therapy for COVID-19 and the development of hip AVN is a noteworthy concern even though no relationship is evident between the duration of treatment, cumulative dosage of medication, maximum daily dosage received, and presence of AVN. Further research with larger cohorts and long-term follow up is needed to better understand the causative relationship and optimal management strategies for hip AVN in the context of COVID-19 and steroid therapy.
新冠疫情给全球医疗系统带来了诸多挑战，新出现的证据表明，新冠治疗，尤其是类固醇疗法，与髋部缺血性坏死（AVN）的发生之间可能存在联系。本综述旨在全面概述近期研究及病例报告，这些研究探讨了新冠、皮质类固醇疗法与AVN发生之间的关系。在新冠背景下了解AVN的细微差别，对于医疗专业人员做出治疗决策和减轻潜在并发症至关重要。
在2023年9月1日前的系统评价中采用了系统评价和Meta分析的首选报告项目（PRISMA）。本综述的作者独立审查了其余23篇文章的全文。
尽管在治疗持续时间、药物累积剂量、每日最大剂量与AVN的存在之间未发现明显关联，但新冠类固醇疗法与髋部AVN的发生之间的关联仍是一个值得关注的问题。需要开展更大样本队列的进一步研究和长期随访，以更好地了解新冠和类固醇疗法背景下髋部AVN的因果关系及最佳管理策略。
