Long Covid: Now steroids-linked 'bone death' a new worry: What are the symptoms of avascular necrosis?

New Delhi, July 05: At least three confirmed cases of avascular necrosis after Covid-19 have been scientifically reported from Mumbai, and doctors fear more are likely in the next few months. The common factor between mucormycosis and avascular necrosis is the use of steroids, the only drug that was proven to help Covid patients, reported TOI.

Patients were symptomatic and developed early Avascular necrosis 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 Avascular necrosis post steroid exposure.

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 Avascular necrosis.

What is Avascular necrosis?

Avascular necrosis is the death of bone tissue due to a lack of blood supply. Also called osteonecrosis, it can lead to tiny breaks in the bone and the bone's eventual collapse.

A broken bone or dislocated joint can interrupt the blood flow to a section of bone. Avascular necrosis is also associated with long-term use of high-dose steroid medications and excessive alcohol intake.

Anyone can be affected, but the condition is most common in people between the ages of 30 and 50.

Symptoms

Many people have no symptoms in the early stages of avascular necrosis. As the condition worsens, your affected joint might hurt only when you put weight on it. Eventually, you might feel the pain even when you're lying down.

Pain can be mild or severe and usually develops gradually. Pain associated with avascular necrosis of the hip might center on the groin, thigh or buttock. Besides the hip, the areas likely to be affected are the shoulder, knee, hand and foot.

Some people develop avascular necrosis on both sides (bilaterally) - such as in both hips or in both knees.

Causes

Avascular necrosis occurs when blood flow to a bone is interrupted or reduced. Reduced blood supply can be caused by:
Joint or bone trauma
Fatty deposits in blood vessels
Medical conditions, such as sickle cell anemia and Gaucher's disease

Prevention

To reduce your risk of avascular necrosis and improve your general health:

• Limit alcohol.
• Keep cholesterol levels low.
• Monitor steroid use.
• Steroid-related bone damage appears to worsen with repeated courses of high-dose steroids.
• Don't smoke