Postacute sequelae of SARS-CoV-2 infection. Osteonecrosis must not be overlooked

International Journal of Infectious Diseases, Год журнала: 2022, Номер 121, С. 11 - 13

Опубликована: Апрель 21, 2022

Recovery from COVID-19 is not always uneventful, especially in critically ill hospitalized patients. Persistent symptoms including fatigue/ weakness, shortness of breath, anxiety, and depression have been described at one-year follow-up. Furthermore, the musculoskeletal system like joint pain or stiffness are underreported studies with long-term follow-up up to one year. Infection SARS-CoV-2 itself has associated endothelial damage, together high-dose corticosteroid treatment, it predisposed dissemination microthrombi development femoral head osteonecrosis (FHOn), as shown during previous (2003–2004) coronavirus outbreaks. A resurgence FHOn cases anticipated but this reflected existing Prompt diagnosis critical for early treatment possibly hip preservation. Patients treated corticosteroids should be screened avascular necrosis after discharge hospital. Every healthcare worker involved management these patients maintain a high level suspicion alert when report such vague aches buttocks, area, adductors, and/or above knee. Studies needed identify risk factors disease severity, type steroid, cumulative dose, duration treatment.

Язык: Английский

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Dose–Response Meta-Analysis of Corticosteroid Effects in SARS Outbreak: A Model for Risk Stratification and Screening Strategy for Osteonecrosis of Femoral Head Post-Corticosteroid Therapy for COVID-19

Life, Год журнала: 2023, Номер 13(4), С. 907 - 907

Опубликована: Март 29, 2023

Corticosteroids (CS) have been used in the management regimens for COVID-19 disease to mitigate cytokine storm and ill effects of pulmonary inflammatory cascade. With rampant use CS, clinicians started reporting occurrence osteonecrosis femoral head (OFH). In this systematic review, we aim analyze literature identify definitive cumulative dose duration CS needed development OFH based on SARS model generate a risk-based screening recommendation convalescent patients facilitate early identification management. An electronic database search was conducted until December 2022 PubMed, Web Science, Embase, CNKI (China Knowledge Resource Integrated Database). Studies involving therapy data were included. Three authors independently extracted from included studies dose–response meta-analysis performed various doses utilized studies. We selected 12 articles with 1728 analysis. The mean age 33.41 (±4.93) years. dosage administered 4.64 (±4.7) g which 29.91 (±12.3) days. risk increases at pooled OR 1.16 (95% CI 1.09–1.23, p < 0.001) per 2.0 increase usage. Similarly, 1.02 1.01–1.03, 5 days A 4 15 determined as critical cut-off non-linear relationship observed. Appropriate frequent these individuals regular intervals would help an stage order treat them appropriately.

Язык: Английский

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Increasing autoimmune rheumatic diseases as a consequence of the COVID‐19 pandemic: A hypothesis or fact?

International Journal of Rheumatic Diseases, Год журнала: 2023, Номер 27(1)

Опубликована: Дек. 22, 2023

The consequences of the Coronavirus Disease 2019 (COVID-19) pandemic, caused by Severe Acute Respiratory Syndrome 2 (SARS-CoV-2), will have a lasting effect on health global population. This disease most likely be viewed as plague 21st century. true toll COVID-19 pandemic is difficult to estimate due its immediate and delayed consequences. Reportedly, about 700 mLn people worldwide been infected with SARS-CoV-2 7 them died (https://www.worldometers.info/coronavirus/). In post-pandemic period, upsurge autoimmune rheumatic diseases (ARDs) has observed among survivors those exposed vaccinations. mainstream rheumatology sources including International Journal Rheumatic Diseases (IJRD) taken lead in discussing clarifying plausible associations between autoimmunity.1, Importantly, this year's Annual European Congress Rheumatology arranged special session titled "Can induce autoimmunity musculoskeletal diseases?" (EULAR 2023 Debate, June 2023). latest editorial IJRD uncovered association Rheumatoid Arthritis (RA)1 referred our study definite RA after exposure SARS-CoV-2.3 commonest prototype ARD. spreading may reflect trends. As such, we aimed analyze official morbidity records Kazakhstan, Kyrgyzstan, Uzbekistan, Tajikistan peri-pandemic period (2019–2022), year took last before pandemic. We formulated research question reveal any trend numbers 3 years. retrieved from statistical yearbooks four Central Asian countries. analysis data revealed substantial increase absolute relative number patients was registered dispensary follow-up subjects newly diagnosed diseases. Kazakhstan elevated 41 044 2020 66 018 2022, accounting for 61% increase. Such an accompanied disproportionately slow general Kazakhstani population (10.4% past years). Uzbekistan Kyrgyzstan accounted 29% 31%, respectively, during same period. Tajikistan, increased 24.4% (from 10 541 13 112 2022) while 5.8%. Back 2020, presented hypothesis potential trigger at APLAR congress published related abstract October 2020. hypothesis, enriched growing evidence, discussed publication 2022.4 With time passing accumulating similar hypotheses COVID-19-induced were tested large studies crystallizing scientific fact association. Indeed, cohort Taiwan, Germany, UK, South Korea, 2023, confirmed that infection associated ARD morbidity.5-8 Notably, German 641 704 COVID-19, matched controls, there 43% higher likelihood acquiring new within 3–15 months infection.6 vaccination campaign raised concerns over scale adverse outcomes autoimmunity. numerous cases vaccination-associated described, generating hypotheses.9 vaccinations saved millions lives changed course Nonetheless, coupled infections could triggering predisposed established ARDs.10 Osteonecrosis yet another big issue amid pandemic.11, 12 Several factors implicated pathophysiology debilitating complication which irrational corticosteroid therapy. It seems developing world, central countries, encounter osteonecrosis unjustified widespread use corticosteroids outpatient inpatient settings. Rheumatologists like no other specialists are familiar severe complications therapies take timely diagnosing managing aftermath Admittedly, ARDs not entirely A recent article series Lancet disorders 30 years, unrelated pandemic.13-15 Moreover, shown natural selection mutations genes responsible innate immunity led resistance infections, coming cost inflammatory human populations.16 An increasing interest these continuously advancing diagnostics also contribute impressive ARDs. For instance, qualified rheumatologists doubled partly contributing statistics field. To sum up, had profound landscape necessitates more concerted actions national regional levels. expected stretching resources. action rheumatologists, who member APLAR, increasingly important face need training specialists, expanding units, supplying drugs. come reach consensual statement rheumatologists.17 serve platform initiating discussion whereas help launch working group recommendations. Chokan Baimukhamedov wrote manuscript input all authors. All authors reviewed results approved final version manuscript. None. None declared. Data sharing applicable created or analyzed study.

Язык: Английский

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Screening for Femoral Head Osteonecrosis Following COVID-19: Is It Worth It?

PubMed, Год журнала: 2023, Номер 11(12), С. 731 - 737

Опубликована: Янв. 1, 2023

Based on WHO data, as of June 2022, there were 532.2 million confirmed COVID-19 cases globally. In the initial phase COVID -19 pandemic, patients experiencing critical illness marked by severe respiratory distress commonly subjected to corticosteroid treatment. Regrettably, administration exogenous corticosteroids stands prevailing cause ONFH. current narrative review, we aim evaluate if active screening should be utilized diagnose post-COVID-19 ONFH in its early stages.The databases for PubMed, CINAHL, and Science Direct systematically queried March 2022. The search terms follows: "COVID-19", "severe acute syndrome", "coronavirus", "systemic steroid", "corticosteroid", "femoral head osteonecrosis", "avascular necrosis", or "steroid therapy." included studies review all required peer-reviewed English language with Reported complications linked steroid therapy potential connections development individuals recovering from novel coronavirus have been documented.Systemic frequently employed managing critically ill patients. CDC reports up 2022 showed more than 4.8 hospitalizations US, approximately over one receiving steroids. a study after infection COVID-19, had bilateral involvement. average duration initiation treatment onset symptoms was 132.8 days.In summary, distinct correlation exists between steroids subsequent risk Moreover, an elevated dosage prolonged are associated increased likelihood developing Therefore, high-risk patients, that may received systemic during illness, reasonable.

Язык: Английский

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Avascular Necrosis of the Hip Joint and Femoral Head Related with Long COVID-19 or Post-COVID-19: Case Report Study

Open Access Macedonian Journal of Medical Sciences, Год журнала: 2024, Номер 12, С. 1 - 7

Опубликована: Фев. 25, 2024

BACKGROUND: Post-COVID conditions can include a wide range of ongoing health problems. As consequence long COVID-19 or post-COVID-19 an increase in osteonecrosis has been detected different series patients. CASE PRESENTATION: We present two patients diagnosed with and pneumonia, one moderate the other severe clinical picture. They were treated corticosteroid equivalent to prednisolone 993.5 mg (400–1587 mg) which correlates steroid dose documented literature as causative for avascular necrosis (ANV) COVID-19. After mean time 65 days, due pain groin difficulty movement, magnetic resonance imaging (MRI) was performed both AVN diagnosed. Compared our results, records longer required development without COVID-19, is 6–36 months. This indicates potency virus itself cause disturbances microcirculation, thus AVN. The bone damage degree inflammation severity CONCLUSION: course part ANV should be considered possible complication, especially who have manifestations. Early detection diagnosis using MRI on suspicion would help early intervention bisphosphonate therapy hip. If disease more advanced stage, it necessary perform surgical even hip replacement.

Язык: Английский

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Osteonecrosis of the Knee: The Unintended Consequence of Steroid Abuse

Clinical Medicine & Research, Год журнала: 2024, Номер 22(1), С. 37 - 43

Опубликована: Март 1, 2024

Suhas Sondur, MBBS, D'Ortho, MS*⇑, Govid VJ, MS* and Shakti Prasad Das, DNB* *Department of Orthopaedics, Kalinga Institute Medical Sciences, KIIT University, Bhubaneshwar, Odisha, India, Pin: 751024 Corresponding Author: Dr. Department Orthopaedics 751024, Email: sondur.suhas{at}gmail.com, Tel: +91 7259959943 ORCID ID: 0000-0003-1749-4871

Язык: Английский

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Two Cases of COVID-Related Osteonecrosis of the Jaws: A New and Worrying Entity Is Emerging

WORLD JOURNAL OF PLASTIC SURGERY, Год журнала: 2024, Номер 13(1), С. 96 - 102

Опубликована: Янв. 1, 2024

Many people were affected by COVID-19 in its severe form. Some intercurrences are still emerging. We here report two cases of COVID-related osteonecrosis the jaws (CRONJ). Two retrospective admitted into Imam Reza Hospital, Mashhad, Iran with suspected CRONJ. One patient escaped from hospital while other showed a positive result after our proposed treatment. A new aftermath to infections is Maxillofacial and orthopedic surgeons should be aware this situation. CRONJ on suspect list patients COVID-19. Measures that useful treatment carried out, as well some measures recommended literature, discussed. Surgical appears an effective alternative, especially more aggressive cases.

Язык: Английский

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Avascular necrosis of bone tissue: Definition, epidemiology, types, risk factors, pathogenesis of the disease. Analytical review of the literature

Rheumatology Science and Practice, Год журнала: 2023, Номер 61(2), С. 220 - 235

Опубликована: Апрель 28, 2023

Avascular necrosis (AN) of bone tissue is a common pathology that affects people any age, more often young and able-bodied. The disease leads to rapid destruction the subchondral collapse, followed by development secondary osteoarthritis (OA) affected joint. purpose this review article present accumulated knowledge about prevalence AN, most commonly joints, risk factors pathogenesis disease. Since world’s literature sources individual parts facts make up analyzes all known paths from onset ischemia collapse OA presented in chronological order. Based on results article, definition term AN was proposed, stages within pathogenesis, promising for conservative methods treatment, were identified.

Язык: Английский

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Multifocal osteonecrosis as a consequence of a new coronavirus infection

Rheumatology Science and Practice, Год журнала: 2023, Номер 61(1), С. 34 - 41

Опубликована: Март 2, 2023

The impact of the transferred coronavirus infection on musculoskeletal system still remains an urgent problem. Аrthralgia, myalgia, arthritis, autoimmune disorders and also osteonecrosis are may be development postCOVID period. This article discusses case debut multifocal after a infection.

Язык: Английский

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Postcovid necrosis of the cranio-maxillofacial region

Kazan medical journal, Год журнала: 2023, Номер 104(4), С. 552 - 563

Опубликована: Июнь 28, 2023

The review article is devoted to one of the new topical problems in medicine necrosis organs cranio-maxillofacial region patients with coronavirus infection, which was first discussed at end 2020. Later, doctors various specialties (otolaryngologists, ophthalmologists, maxillofacial surgeons, neurosurgeons, dentists) from many countries world met their practice inflammatory-necrotic lesions mucous membrane nasal cavity and paranasal sinuses, facial skeleton skull, eyeball, brain. highlights main points view scientists about etiology pathogenesis studied pathology. Summarized data largest studies on epidemiology, risk factors, symptoms post-covid are presented. results methods for diagnosing this complication multislice computed tomography, magnetic resonance imaging, angiography, described detail. Due fact that today role fungal flora recognized as leading region, much attention paid cytological, microbiological pathohistological research methods, should be aimed search mycelium. approaches treatment pathology formulated. issues important practical healthcare: interpretation national clinical guidelines infection terms classification options according International Classification Diseases 10th revision, procedure providing medical care category patients, economic consequences lack active prevention presented COVID-19.

Язык: Английский

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