Bone Deaths in Mumbai – Burning Issues – Free PDF Download

Bone Death –a new condition among covid survivors

• Three confirmed cases of avascular necrosis or death of bone tissues after Covid-19 have been scientifically reported from Mumbai.
• AVN could be the next debilitating condition among post-Covid patients after the outbreak of mucormycosis or black fungus two months back.
• Doctors fear that more cases of AVN are likely in the next few months.
• AVN is the death of bone tissues due to a lack of blood supply. It can lead to tiny breaks in the bone, causing the bone’s eventual collapse. Though anyone can get affected by it, the condition is most commonly seen in people aged between 30 and 50. Treatments for the disease include physiotherapy, surgery, and medication.

• The common factor between AVN and mucormycosis is the use of steroids, the only drug proven to help Covid-19 patients. 
• Avascular necrosis as a part of long Covid-19’, – the paper ,  was published on Saturday in prestigious medical journal ‘BMJ Case Studies’.
• it said that “large-scale use of life-saving corticosteroids” in Covid-19 cases will result in a “resurgence of AVN cases”.

• Steroids can save the lives of patients with severe COVID-19 infection. Steroids used in COVID-19 are dexamethasone, methy/prednisolone.
• Patients with severe COVID-19 can develop a systemic inflammatory response that can lead to lung injury and multisystem organ dysfunction. The potent anti-inflammatory effects of steroids might prevent deleterious effects.

Avascular necrosis as a part of long Covid-19 – study

• the study underlines two worrying trends: post-Covid patients had lower threshold dose of steroid and earlier onset of presentation. They were given a mean dose of 758mg of corticosteroid prednisolone that is less than the 2,000mg dosage known to trigger AVN.
• Secondly, it usually takes six months to a year to develop AVN after post-steroid use. “But our set of patients developed early AVN at a mean of 58 days after their diagnosis,”
• Doctors say cases of AVN are expected to rise in the next few months because the condition “usually occurs five to six months after steroid use.“
•  “Our second COVID-19 wave’s peak was in April when steroids were liberally used to treat patients, so we may see it soon,”

• “Covid-19 survivors, who have been on steroids, and then develop hip or thigh pain, need confirmatory MRI to establish a diagnosis of AVN of the hip. If they are started on early bisphosphonate therapy, they can have reversal of the disease.

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