Mumbai: The deadly Covid-19 pandemic has opened a Pandora box of conditions and complexities that can be fatal to the patients who may won the battle against the Coronavirus but can’t escape the debilitating conditions emerged after the treatment.
After the outbreak of mucormycosis or black fungus two months back, a new condition -vascular necrosis, or death of bone tissues – has left the doctors worrying for Covid patients receiving steroids treatment.
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 proven to help Covid patients.
Hinduja Hospital, Mahim, treated the three young (under 40) patients who developed necrosis two months after they were treated Covid. “They developed pain in their femur bone,” said Sanjay Agarwala, medical director of Hinduja Hospital. His research paper, ‘Avascular necrosis as a part of long Covid-19’, was published on Saturday in BMJ Case Studies.
Other orthopedic specialists told media they too had seen one or two cases among post-Covid patients.
His study underlines two trends: 1) Post-Covid patients had lower threshold dose of steroid and earlier onset of presentation. They were given a mean dose of 758mg of corticosteroid prednisolone that is less than the 2,000mg dosage known to trigger AVN.
2) It usually takes six months to a year to develop AVN after post-steroid use. “But these patients developed early AVN at a mean of 58 days after their diagnosis,” he said.
“Covid survivors, who have been on steroids, and then develop hip or thigh pain, need confirmatory MRI to establish a diagnosis of AVN of the hip,” he said.