Osteonecrosis Development Post Covid-19 Infection
04 Aug 2021-
About: The article was published on 2021-08-04. It has received 2 citations till now.
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TL;DR: COVID-19 infection alone and corticosteroids given to treat it can increase the incidence of avascular necrosis of the femoral head and can reduce patient’s disability and need for surgery.
Abstract: Aim: Avascular necrosis of the femoral head is a condition characterized by limited range of motion,
pain, and gait disturbance resulting from insufficient blood flow. We aim to evaluate the relationship
between COVID-19 and avascular necrosis.
Case: Herein, we present a 63-year-old male patient who developed avascular necrosis of the bilateral
femoral head after COVID-19.
Conclusion: COVID-19 infection alone and corticosteroids given to treat it can increase the incidence
of avascular necrosis of the femoral head. MRI of the hip is highly specific in detecting early stagea
vascular necrosis of the femoral head and can reduce patient’s disability and need for surgery.
3 citations
TL;DR: In this paper , the authors found an association between COVID-19 infection and avascular femoral head necrosis, a condition brought on by insufficient blood flow, which is characterized by a restricted range of motion, pain, and disturbance of gait.
Abstract: Introduction: Despite having a substantial impact on survivors' mobility and leading to morbidity, musculoskeletal involvement was the post-COVID-19 infection sequelae area that received the least attention in the literature. Reviewing the COVID-19 histories of patients who visited a tertiary health center, the research is aimed at finding an association between COVID-19 infection and avascular femoral head necrosis, a condition brought on by insufficient blood flow. Avascular necrosis of the femoral head is a condition characterized by a restricted range of motion, pain, and disturbance of gait. It is brought on by insufficient blood flow. Case reports: We discussed several examples in which COVID-19 caused individuals to develop bilateral femoral head necrosis. When COVID-19 infection is the only factor present, and corticosteroids are used to treat it, avascular necrosis of the femoral head may become more prevalent. Detecting avascular necrosis of the femoral head in its early stages, hip MRI might reduce the patient's disability and need for continuous treatment. Conclusion: Early identification and treatment of AVN patients reduce the need for surgery and the chance of disabilities.
References
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TL;DR: Compared with osteoclasts modulating the osteoblast-suppressive effect of DEX, GRoc-/- mice are protected from the steroid's inhibition of bone formation, suggesting that an intermediary cell transmits a component of the bone-suppression effects of GCs to osteoblasts in the intact animal.
Abstract: The pathogenesis of glucocorticoid-induced (GC-induced) bone loss is unclear. For example, osteoblast apoptosis is enhanced by GCs in vivo, but they stimulate bone formation in vitro. This conundrum suggests that an intermediary cell transmits a component of the bone-suppressive effects of GCs to osteoblasts in the intact animal. Bone remodeling is characterized by tethering of the activities of osteoclasts and osteoblasts. Hence, the osteoclast is a potential modulator of the effect of GCs on osteoblasts. To define the direct impact of GCs on bone-resorptive cells, we compared the effects of dexamethasone (DEX) on WT osteoclasts with those derived from mice with disruption of the GC receptor in osteoclast lineage cells (GRoc-/- mice). While the steroid prolonged longevity of osteoclasts, their bone-degrading capacity was suppressed. The inhibitory effect of DEX on bone resorption reflects failure of osteoclasts to organize their cytoskeleton in response to M-CSF. DEX specifically arrested M-CSF activation of RhoA, Rac, and Vav3, each of which regulate the osteoclast cytoskeleton. In all circumstances GRoc-/- mice were spared the impact of DEX on osteoclasts and their precursors. Consistent with osteoclasts modulating the osteoblast-suppressive effect of DEX, GRoc-/- mice are protected from the steroid's inhibition of bone formation.
358 citations
TL;DR: The purpose of this article was to summarize the known musculoskeletal pathologies in patients with SARS or COVID-19 and to combine this with computational modeling and biochemical signaling studies to predict musculOSkeletal cellular targets and long-term consequences of the SARS-CoV-2 infection.
Abstract: Coronavirus disease 2019 (COVID-19) is an emerging pandemic disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the majority of patients who become infected with SARS-CoV-2 are asymptomatic or have mild symptoms, some patients develop severe symptoms that can permanently detract from their quality of life. SARS-CoV-2 is closely related to SARS-CoV-1, which causes severe acute respiratory syndrome (SARS). Both viruses infect the respiratory system, and there are direct and indirect effects of this infection on multiple organ systems, including the musculoskeletal system. Epidemiological data from the SARS pandemic of 2002 to 2004 identified myalgias, muscle dysfunction, osteoporosis, and osteonecrosis as common sequelae in patients with moderate and severe forms of this disease. Early studies have indicated that there is also considerable musculoskeletal dysfunction in some patients with COVID-19, although long-term follow-up studies have not yet been conducted. The purpose of this article was to summarize the known musculoskeletal pathologies in patients with SARS or COVID-19 and to combine this with computational modeling and biochemical signaling studies to predict musculoskeletal cellular targets and long-term consequences of the SARS-CoV-2 infection.
244 citations
DOI•
01 Sep 2005TL;DR: Three patients who developed axonopathic polyneuropathy 3-4 weeks after onset of SARS; their clinical condition and electrophysiological studies revealed obvious improvement at follow-up, but the relationship between SARS and above neurological problems still needs further clarification.
Abstract: During the worldwide outbreak of severe acute respiratory syndrome (SARS) in 2002-2003, there were 664 probable SARS patients reported in Taiwan. SARS patients usually present with symptoms related to the respiratory system while neurological manifestations have rarely been described. There were three patients who developed axonopathic polyneuropathy 3-4 weeks after onset of SARS; their clinical condition and electrophysiological studies revealed obvious improvement at follow-up. Two SARS patients have experienced myopathy and three other patients developed rhabdomyolysis. These neuromuscular disorders in SARS patients were considered as critical illness neuropathy and myopathy, but the possibility of direct attack by SARS coronavirus on the nerve and muscle could not be excluded. Large artery ischemic stroke were described in five SARS patients with poor prognosis. Multiple factors contributed to this vascular insult included hypercoagulabe status related to both SARS coronavirous and the usage of intravenous immunoglobulin, septic and cardiogenic shock, and possible vasculitis. The relationship between SARS and above neurological problems still needs further clarification. Pathological and microbiological studies are mandatory to delineate this issue.
195 citations
TL;DR: In advanced stages of femoral head osteonecrosis, total hip arthroplasty appears to be the best therapeutic modality, particularly in older individuals.
161 citations
TL;DR: Tele-rehabilitation offers a quick and effective option to respond to the specialist rehabilitation needs of COVID-19 survivors following hospital discharge by using digital communication technology to offer quick remote assessment and efficient therapy delivery.
Abstract: A global pandemic of a new highly contagious disease called COVID-19 resulting from coronavirus (severe acute respiratory syndrome (SARS)-Cov-2) infection was declared in February 2020. Though primarily transmitted through the respiratory system, other organ systems in the body can be affected. Twenty percent of those affected require hospitalization with mechanical ventilation in severe cases. About half of the disease survivors have residual functional deficits that require multidisciplinary specialist rehabilitation. The workforce to deliver the required rehabilitation input is beyond the capacity of existing community services. Strict medical follow-up guidelines to monitor these patients mandate scheduled reviews within 12 weeks post discharge. Due to the restricted timeframe for these events to occur, existing care pathway are unlikely to be able to meet the demand. An innovative integrated post-discharge care pathway to facilitate follow up by acute medical teams (respiratory and intensive care) and a specialist multidisciplinary rehabilitation team is hereby proposed. Such a pathway will enable the monitoring and provision of comprehensive medical assessments and multidisciplinary rehabilitation. This paper proposes that a model of tele-rehabilitation is integrated within the pathway by using digital communication technology to offer quick remote assessment and efficient therapy delivery to these patients. Tele-rehabilitation offers a quick and effective option to respond to the specialist rehabilitation needs of COVID-19 survivors following hospital discharge.
91 citations