Avascular Necrosis Bone Complication after Active COVID-19 Infection: Preliminary Results.

Adam Sulewski,Mikołaj Dąbrowski,Dawid Lukoszek,Andreas Christe,Dominik Sieroń,Karol Szyluk,Łukasz Kubaszewski

doi:10.3390/medicina57121311

Abstract

Background and objectives: The course of SARS-CoV-2 (COVID-19) is still under analysis. The majority of complications arising from the infection are related to the respiratory system. The adverse effect of the viral infection on bone and joint tissue has also been observed. Materials and Methods: We present a group of 10 patients with degeneration of large joints and adjacent epiphyses of long bones and the spine, with a background of bone infarctions and avascular necrosis (AVN) immediately after infection with the COVID-19 virus. In MR imaging, changes in the characteristics of AVN were documented. Results: Observation of this group showed a clear correlation among the history of COVID-19 disease in the patients, moderately severe symptoms, high levels of IgG antibodies, and the time of occurrence of joint changes. No other clinically significant complications were observed following COVID-19 infection in the study group. No other risk factors for AVN or autoimmune or degenerative diseases were found in the study group. The group of patients responded well to empirical treatment with steroids, which normalized acute inflammatory symptoms and pain in the joints. Conclusions: During coronavirus (COVID-19) infection, there are complications in the locomotor system, such as microembolism and the formation of AVN; hence, more research is needed.

Highlights

The coronavirus 2 (SARS-CoV-2) (COVID-19) pandemic has stimulated an unprecedented response by the global scientific community to better understand the disease
Systemic inflammation may play a role in the physiology of bone and joint tissue in COVID-19 patients [1]
The study included a group of ten patients who developed symptoms of joint dysfunction, which were classified as avascular bone necrosis in COVID-19 on MR images [6]

Summary

Introduction

The coronavirus 2 (SARS-CoV-2) (COVID-19) pandemic has stimulated an unprecedented response by the global scientific community to better understand the disease. Various hypotheses have been formulated in regard to its pathogenetic mechanisms and treatment [1]. A plethora of reports on the long-term consequences of the infection, which include the musculoskeletal system, have been published [2]. Systemic inflammation may play a role in the physiology of bone and joint tissue in COVID-19 patients [1]. Cytokines that are induced by COVID-19 include CXCL10, IL-17, and TNF-alpha [2]. They are responsible for reducing the proliferation and differentiation of osteoblasts

Methods

Results

Discussion

Conclusion