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Case report
Avascular necrosis as a part of ‘long COVID-19’
  1. Sanjay R Agarwala1,
  2. Mayank Vijayvargiya2 and
  3. Prashant Pandey2
  1. 1Orthopaedics, PD Hinduja National Hospital, Mumbai, Maharashtra, India
  2. 2Orthopaedics, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
  1. Correspondence to Dr Sanjay R Agarwala; drsa2011{at}gmail.com

Abstract

‘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.

  • COVID-19
  • musculoskeletal and joint disorders
  • unwanted effects/adverse reactions
  • groin pain
  • drugs: musculoskeletal and joint diseases

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2021-242101

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    Footnotes

    • Contributors All authors have equally contributed towards the planning, conduct, reporting, conception and design, acquisition of data or analysis and interpretation of data.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.