Online ISSN: 2515-8260

Fear of avascular necrosis in COVID survivors is real: A rare case series

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Dr. Arjun A, Dr. Gopi HG, Dr. Kiran V, Dr. Chaithra CM, Dr. Nagesh Sherikar

Abstract

COVID-19’ can affect different body systems. At present, osteo necrosis of femoral head as a sequalae of ’COVID-19’ is rarely 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 two cases in which patients developed AVN of the femoral head after being treated for COVID-19 infection. The mean dose of corticosteroid used in these cases was 600 mg (400–1250mg), 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 of bilateral hip at a mean of 42 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. Both the patient had significant dysfunction of coagulation with altered parameters. Thorough ophthalmic examination was done to both. literature has showed micro thrombi in eye, heart, liver, kidney, etc. Is corticosteroid being just a confounding factor??

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