Proportion of Avascular Necrosis of Femoral Head in Coronavirus Disease 19 Patients

Clarify the distinctive characteristics of avascular necrosis of the femoral head (AVNFH) in relation to coronavirus disease 19 (COVID-19) and report the successive individuals who were identified with the condition after recovering from COVID-19.

From August 2023 to July 2024, we examined 24 successive patients (35 hips) prospectively who received an AVNFH diagnosis after recovering from COVID-19. Twenty patients were on corticosteroids for the treatment of COVID-19. The staging of AVNFH was decided by plain radiographs and magnetic resonance imaging. An association between the stage with the dosage of steroids and the comorbidities was evaluated.

After COVID-19, hip symptoms took a mean of 6.13 months to manifest. In Methylprednisolone equivalent, the average steroid dosage was 713.2 mg. For those on steroid medication, the mean time for COVID-19 before hip complaints was 5.95 months. It was discovered that the mean COVID-19 period before the onset of hip symptoms was 7.125 months for individuals without comorbidities and 3 months for those with both diabetes and hypertension.

There has been an increase in AVN during the pandemic. This rise is probably because patients with COVID-19 pneumonia were receiving severe doses of corticosteroids. There is also an increase in severity and decrease in the duration of COVID-19 before hip symptoms in patients with comorbidities like diabetes. Given the minimal total amount of steroids taken by our patients, it is possible that vasculitis-associated COVID-19 contributes to the pathophysiology of AVN of the femur head.