Osteonecrosis Development Post Covid-19 Infection

Abstract

The COVID19 pandemic, originating in China, has spread across the world, with serious proportions in populations and public health. Systemic lesions in those infected generate cascading changes affecting different organs. Osteonecrosis is a bone pathology, of different etiologies, common throughout the world, which directs the hip to a disabling condition. Furthermore, there is a polygenic and multifactorial interaction in its pathophysiology. The objective of this paper is to present the first series of cases of osteonecrosis of the femoral head after infection by SARS-CoV-2 and to discuss the possible pathological mechanisms. This is a sample with a male majority with a mean age of 43.5 years, bilateral involvement of the hip sin 100% of cases, mean time between infection and onset of symptoms was 132.8 days. About 33% had osteonecrosis of the femoral head after a mild infection, 66% were moderate or severe cases that used corticosteroid therapy with a minimum dose of 40mg/day of dexamethasone for an average time of 14.6 days. We believe that the association of hypercoagulability mechanisms inherent to COVID-19, direct cell infection and instituted cortico therapy may be responsible for the high incidence of osteonecrosis in the post-covid syndrome.