Avascular necrosis (AVN), bone tissue death due to lack of blood supply may affect patients who have undergone Covid-19. So far 3 cases of avascular necrosis have been confirmed in Mumbai and doctors fear the fact that it may spread even more in the coming months.
The link between mucormycosis and avascular necrosis is the use of steroids, the only drug that seems to help patients with Covid-19. At the Hindu hospital, Mahim, 3 patients under the age of 40 were treated who developed vascular necrosis two months after infection with Covid.
“These patients developed pain in the femur (upper thigh bone) and since they were doctors, they recognized the symptoms and immediately started treatment,” said Dr Sanjay Agarwala, director of the Hindu Hospital, Mahim.
Dr Agarwala published a report ‘Avascular necrosis as part of’ Prolonged Covid ‘on Saturday in the prestigious medical journal BMJ Case Study. He said that “the widespread use of steroids leads to a resurgence of AVN cases. Other orthopedic specialists stated that they had found one or two cases among patients after infection with Covid, reports abcnews.al
“For patients who have suffered from prolonged Covid and need steroid treatment, this is a concern,” said a hospital doctor.
Dr Rahul Pandit, a member of the Covid-19 Task Force who is studying avascular necrosis, said: “Usually AVN cases occur 6 months after steroid treatment. The peak of the second wave of Covid was in the April-period when patients were treated with steroids.
But Dr Agarwala, who is known as a specialist in avascal necrosis, initiated a medical treatment (called bisphosphonate) 20 years ago, but that apparently has now begun to take effect.
His study touches on two troubling trends: patients who have switched to Covid received a lower dose of steroids. They were given an average dose of 758 mg which is less than the 2,000mg dose caused by AVN.
Second, it usually takes six months to a year to develop AVN after steroid use.
“But our patients developed AVN 58 days after their diagnosis,” said Dr Agarwala.
Since these patients sought help, they did not need surgery, a common intervention for vascular necrosis.
“Survivors of Covid-19 who have been treated with steroids and then developed bone pain should take bisphosphonates. “Their symptoms will improve immediately,” said Dr Agarwala.