As India continues combatting the aftermath of the second wave of the fatal COVID-19, doctors have recently established a connection between patients with the virus and Avascular Necrosis or AVN also called bone death.
An India Today report describes AVN as a painful condition impacting the hip joint and thigh bones of COVID-19 patients, which adds to the long list of post-COVID-19 complications among patients who have recovered.
Head of orthopedics and traumatology Dr. Sanjay Agarwala, together with Dr. Mayank Vijayvargiya at PD Hinduja Hospital & MRC Mumbai has worked on a medical paper on their findings, which has been accepted for publication. The two doctors discussed about the medical condition, which is a side effect of COVID-19.
Bone Death Detected in Recovered Patients
The post-COVID-19 complication came to light when Dr. Manish Khobragade, a patient who recovered from COVID-19 suddenly developed pain in his left hip joint.
The report, "Avascular necrosis as a part of 'long COVID-19'" published in the BMJ Journals specified, he, at first thought that it was mere joint pain, although since it did not recede even after one week he contacted an orthopedic surgeon and was advised to undergo an X-ray test.
The X-Ray did not detect any glaring problems and the patient was thus, prescribed regular medications, pain killers, and muscle relaxers. However, even after one month and half the doctors did not feel any relief.
Khobragade explained that it was at that point that he realized the pain was different from the routine problem, and something was wrong with the hip joint. The doctor then got the MRI done post which he was diagnosed with AVN.
By that time though, he could not even stand for long periods. Even walking turned out to be a difficult task for Dr. Khobragade. He could not even squat at all.
It was at this point, the said report indicated, that the doctor met Dr. Agarwala and consulted about the AVN issue.
Almost six months after the treatment started, the doctor can now walk, climb stairs, squat, and carries on with his day-to-day activities. Nonetheless, the treatment will continue for two to three years more.
Avascular Necrosis or Bone Death
Avascular Necrosis, as described by ABP Live, is a condition where the blood supply to the bone is getting affected, killing it gradually. That sector of the bone dies, the doctors explained, just like it would in the brain or the heart.
Since it is bone and there is a lot of structure surrounding the bone, it does not essentially collapse abruptly, although it starts to pain.
Doctors explained, it is not something that an individual needs to keep thinking about, for each piece of pain in the bone is not AVN.
The pain can at times be credited to an injury or sprain, as well. Nevertheless, they explained, they know that this can occur in the hip.
When one gets pain in the hip, and if there is a limitation of movement, the person concerned needs to seek the advice of an orthopedic surgeon.
Essentially, patients who have received steroids that have enhanced lung function, affected because of COVID-19, may be susceptible to get AVN on the hip.
They added, they recognized that since the patient has had a COVID-19 infection, he has a chance of thrombosis of his blood vessels and more possibly due to the fact that he has been on steroids.
COVID-19 Treatment with Steroids
Studies from different parts of the world have suggested that AVN can take place with certain doses of steroids.
To patients identified in Mumbai were given half of the prescribed dose of steroid while going through their COVID-19 treatment.
While the doctors do not support or back that steroids need not be administered, they emphasize that there are higher chances of developing AVN of the hip.
Related information about bone death in recovered COVID-19 patients is shown on Times of India's YouTube video below:
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