Covid-19 Potentially Caused By A Corticosteroid Injection: A Case Report

Abstract

This is a case regarding a 50-year-old female from Maryland, USA, with no pertinent past medical history, presenting with a 1 year history of low back pain, elicited by an exercise-related injury. During this time, she had low back and right buttock pain without radiation or neurological signs. The patient tried and failed conservative measures including OTC medications, oral steroids, and Physical Therapy. Based on the discussion between the physician and the patient, a decision was made to proceed with bilateral L3-S1 lumbar facet joint corticosteroid injections on September 21st, 2020, as she was very low risk for COVID-19. 6 days post-procedure, on September 27th, the patient began developing COVID-like symptoms, including fatigue, DOE and anosmia. She later had a positive COVID-19 test on October 1st, 2020. Contact tracing for the patient did not reveal any recent contacts who had COVID-19, and her contacts tested negative for the virus. An in-depth literature review was conducted regarding the nature of this case. While there were many articles with recommendations on steroid injections for pain interventions, there were no cases found directly linking COVID-19 as caused by such an intervention. It is proposed that, while this may not be the first case of its kind, this may certainly be the first case published in the literature, which can open the door for further investigation