Avascular Necrosis (AVN), or Bone Death is a newly identified post-Covid complication that has been discovered in certain patients who received treatment through steroids. Patients who were given steroids to improve lung function, may be prone to contract AVN. The condition is caused when the blood supply to the bones is affected, resulting in the slow death of the afflicted bone. Since the bone is surrounded by dense skeletal structures it may not collapse immediately but the patient will feel extreme pain. AVN cannot be detected through X-Rays and an MRI is the only sensitive enough test to detect the condition right now.
AVN was detected in three patients in Mumbai's PD Hinduja Hospital in Mahim, two months after they had recovered from Covid, according to a report in India Today. It is a painful condition that affects the thigh bones and hip joints of Covid-19 patients. Dr Sanjay R Agarwala of Hinduja Hospital published a paper titled 'Avascular necrosis as part of Covid-19' in the medical journal BMJ Case Studies where he detailed the diagnosis of AVN in post-Covid patients. He told the news site that the large-scale use of life-saving corticosteroids in Covid-19 cases is expected to cause a resurgence AVN cases.
Covid patients without prior hip or joint problems can also be afflicted with AVN complications. For those afflicted, even walking can become a difficult task.
Presently, early detection of the symptoms of AVN through an MRI makes it possible to reverse the disease immediately. The first three patients who had symptoms of AVN, realised that the pain they were experiencing in their hip was something different. Thus, through early detection, doctors were able to reverse its effects. It can take up to three years to treat the disease completely, however with early detection the pain can start to subside within 3-6 weeks. However, if the treatment is delayed then AVN can get progressive.
Since the onset of the pandemic, 16 patients have received treatment for post-Covid AVN at the hospital. Collaborative research from around the world suggests that AVN can occur with the administration of certain doses of steroids. However, some of these steroids are necessary to improve lung function in patients. So, although doctors are not suggesting stopping the administration of life-saving steroids during critical situations, there are higher chances of contracting AVN of the hip in post-Covid patients who received treatment through steroids.
Edited by Pronoy Basu