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Explorando la asociación entre el COVID-19 y la necrosis vascular: una revisión sistemática
Mohamed Zahed1, Alzahraa Faris Alesawy2, Ziad Samir Zahed3
1Orthopedics, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, GBR.
Cureus
|September 5, 2025
Resumen
La necrosis vascular (AVN) está relacionada con el COVID-19 y el uso de esteroides. Esta revisión confirma la asociación, destacando la necesidad de una prescripción cuidadosa de corticosteroides y un monitoreo de la NAV en los pacientes.
Área de la Ciencia:
- Ortopedia y enfermedades infecciosas
- Investigación de las complicaciones extrapulmonares de las infecciones virales
- Reumatología y Farmacología
Sus antecedentes:
- La necrosis vascular (AVN) se reconoce cada vez más como una complicación después de la infección por COVID-19.
- La terapia con corticosteroides, a menudo utilizada para el COVID-19, es un factor de riesgo conocido para la NVA.
- Comprender esta asociación es crucial para el manejo del paciente.
Objetivo del estudio:
- Revisar y evaluar sistemáticamente la asociación entre el COVID-19, el uso de corticosteroides y el desarrollo de AVN.
- Para sintetizar la evidencia de la literatura existente sobre esta complicación emergente.
- Informar la práctica clínica con respecto a la reducción del riesgo.
Principales métodos:
- Revisión sistemática que se adhiere a las directrices de PRISMA, buscando en cinco bases de datos hasta el 30 de mayo de 2024.
- La inclusión de estudios de cohortes y series de casos de pacientes con COVID-19 diagnosticados con AVN.
- Evaluación del riesgo de sesgo mediante la escala de Newcastle-Ottawa (NOS).
Principales resultados:
- Se incluyeron 13 estudios (9 series de casos, 4 cohortes) en los que participaron 795 pacientes.
- La cadera y la cabeza femoral fueron los sitios más comúnmente afectados.
- Se identificó una asociación significativa entre el COVID-19, el uso de corticosteroides y el desarrollo de AVN.
Conclusiones:
- El COVID-19 y el uso de corticosteroides están significativamente asociados con el desarrollo de la necrosis avascular.
- Los médicos deben estar atentos a los signos de AVN en pacientes tratados con corticosteroides, especialmente después de la COVID-19.
- Se justifica una mayor investigación sobre la fisiopatología y los tratamientos alternativos para reducir el riesgo de AVN.
Palabras clave:
Necrosis de las arteriasLos corticosteroidesel covid-19Osteonecrosis La osteonecrosis es una enfermedadanálisis sistemáticoMás Videos Relacionados
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