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[Avascular necrosis of the hip secondary to long-standing COVID]
F E García-Dobarganes-Barlow1, J M Valadez-Soto1, N Saavedra-Islas1
1Hospital Ángeles Querétaro. México.
Insights
Long COVID, a persistent condition post-COVID-19, may be linked to avascular necrosis, a serious hip condition. This case highlights potential risks even before corticosteroid treatment for Long COVID.
Area of Science:
- Medical research
- Orthopedics
- Infectious diseases
Background:
- Long COVID is defined as persistent symptoms beyond 12 weeks post-COVID-19 infection.
- Corticosteroids are used to manage Long COVID but can predispose patients to avascular necrosis.
- Avascular necrosis is a condition where bone tissue dies due to lack of blood supply.
Observation:
- A 39-year-old male presented with avascular necrosis of the left hip.
- The patient had not yet received corticosteroid treatment for his COVID-19 infection.
- This case raises questions about the direct link between COVID-19 and avascular necrosis.
Findings:
- There is ongoing debate regarding the dosage and duration of corticosteroid therapy required to induce avascular necrosis.
- Some studies suggest a cumulative prednisone dose of 2,000 mg may be a threshold for developing avascular necrosis.
- This case suggests avascular necrosis may occur in the context of COVID-19 independent of corticosteroid treatment.
Implications:
- Further research is needed to understand the potential link between COVID-19 and avascular necrosis.
- Clinical vigilance for avascular necrosis symptoms in Long COVID patients is warranted.
- Total hip arthroplasty offers effective pain relief and functional recovery for advanced avascular necrosis stages.
Abstract:
Long COVID is a term used to describe the long-terms effects of COVID-19 infection that continue for weeks or months after the patient has recovered from COVID-19. Long COVID is defined by the persistence of symptoms beyond 12 weeks from the onset of the disease. Corticosteroids are part of the treatment in this period with good results in controlling the disease; however, it is a predisposing factor for the development of avascular necrosis. We present a clinic case of a young man of 39 years old with diagnosis of avascular necrosis in his left hip, before the administration of corticosteroids for the treatment of COVID-19. There is a lack of consensus about the dosage and duration of steroids required to develop avascular necrosis. Some authors have reported that cumulative dose of 2,000 mg prednisone (or its equivalent) was required for avascular necrosis development. For patients with advanced avascular necrosis stages total hip arthroplasty is an attractive option with excellent outcomes in terms of pain relief and survivorship.
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