Use of steroids a double-edged sword, says doc

Strap: Experts warn of a medical condition called avascular necrosis among people recovering from Covid

Box: “The excessive use of steroids causes marrow edema at bone ends that cuts off its own blood supply. The cases of avascular necrosis (AVN) that are being reported now are definitely more in frequency and they seem to be induced by steroids. In our hospital also, we have seen 8-10 cases so far”. ……….Dr Shubhang Aggarwal, an orthopaedic and robotic joint replacement surgeon

Tribune News Service

Jalandhar, July 12

Doctors have been witnessing various post-Covid complications among patients. Dr Shubhang Aggarwal, an orthopaedic and robotic joint replacement surgeon, NHS Hospital, has raised a concern saying that many patients have been reporting pain in joints, hips, shoulder and knees after having recovered from Covid-19. He said this condition is medically known as avascular necrosis (AVN) and if not managed well, could lead to another devastating post-Covid complication like mucormycosis.

“Though there has been no government data regarding this as an emerging trend, hospitals in many parts of the country have confirmed such cases,” he said.

“The use of steroids during the treatment of Covid-19 is the suspect behind this unnatural bone damage. The excessive use of steroids causes marrow edema at bone ends that cuts off its own blood supply. The cases of avascular necrosis that are being reported now are definitely more in frequency and they seem to be induced by steroids. In our hospital also, we have seen 8-10 cases so far. The condition, which comes into light after three months of the Covid-19 infection, needs immediate medical intervention. If the pain persists, then patients are advised to undergo an MRI which will detect whether it is a case of bone death or not. We suggest surgery in the form of joint replacement in an advanced stage,” said Dr Aggarwal.

However, orthopaedic surgeons are of the opinion that bone deaths are not new. But, the incidences of such conditions have gone up as a side-effect in the patients, who had Covid. “People suffering from shoulder and hip problems shouldn’t ignore this condition and seek medical help on an urgent basis. Ideally, the whole procedure takes nearly three years to treat the disease completely if we have to protect the natural joint, but if the patients respond to the treatment, the pain begins to subside within 3-6 weeks,” the doctor advised.

“Patients, who have been given steroids for improved lung function affected due to Covid-19, are more prone to get AVN of the hip,” Dr Aggarwal added.