<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>BACKGROUND</h3>
<p>Post-COVID conditions can include a wide range of ongoing health problems. As a consequence of long COVID-19 or post-COVID-19 an increase in osteonecrosis has been detected in different series of patients.</p>
</sec>
<sec><h3>CASE PRESENTATION</h3>
<p>We present two patients diagnosed with COVID-19 and pneumonia, one with moderate and the other with severe clinical picture. They were treated with corticosteroid equivalent to prednisolone 993.5 mg (400–1587 mg) which correlates with steroid dose documented in the literature as causative for avascular necrosis (ANV) in patients with COVID-19. After the mean time of 65 days, due to pain in the groin and difficulty in movement, magnetic resonance imaging (MRI) was performed in both patients and AVN was diagnosed. Compared to our results, the literature records a longer time required for the development of AVN in patients without COVID-19, which is 6–36 months. This indicates the potency of the virus itself to cause disturbances in the microcirculation, and thus the development of AVN. The bone damage correlates with the degree of inflammation and the severity of the clinical picture.</p>
</sec>
<sec><h3>CONCLUSION</h3>
<p>After a course of COVID-19 as part of a long COVID-19, ANV should be considered a possible complication, especially in patients who have clinical manifestations. Early detection of AVN and diagnosis using MRI on clinical suspicion would help early intervention with bisphosphonate therapy in patients with osteonecrosis of the hip. If the disease is detected in the more advanced stage, it is necessary to perform a surgical intervention and even a possible hip replacement.</p>
</sec>
</abstract>

BACKGROUND
Post-COVID conditions can include a wide range of ongoing health problems. As a consequence of long COVID-19 or post-COVID-19 an increase in osteonecrosis has been detected in different series of patients.

CASE PRESENTATION
We present two patients diagnosed with COVID-19 and pneumonia, one with moderate and the other with severe clinical picture. They were treated with corticosteroid equivalent to prednisolone 993.5 mg (400–1587 mg) which correlates with steroid dose documented in the literature as causative for avascular necrosis (ANV) in patients with COVID-19. After the mean time of 65 days, due to pain in the groin and difficulty in movement, magnetic resonance imaging (MRI) was performed in both patients and AVN was diagnosed. Compared to our results, the literature records a longer time required for the development of AVN in patients without COVID-19, which is 6–36 months. This indicates the potency of the virus itself to cause disturbances in the microcirculation, and thus the development of AVN. The bone damage correlates with the degree of inflammation and the severity of the clinical picture.

CONCLUSION
After a course of COVID-19 as part of a long COVID-19, ANV should be considered a possible complication, especially in patients who have clinical manifestations. Early detection of AVN and diagnosis using MRI on clinical suspicion would help early intervention with bisphosphonate therapy in patients with osteonecrosis of the hip. If the disease is detected in the more advanced stage, it is necessary to perform a surgical intervention and even a possible hip replacement.

Avascular Necrosis of the Hip Joint and Femoral Head Related with Long COVID-19 or Post-COVID-19: Case Report Study

University Clinic for Respiratory Diseases in Children “Kozle”- Skopje

Department of Infectious Diseases, Medical Faculty

Ss. Cyril and Methodius University of Skopje

University Clinic for Orthopaedic Surgery

Open Access Macedonian Journal of Medical Sciences

This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License.

BACKGROUND
Post-COVID conditions can include a wide range of ongoing health problems. As a consequence of long COVID-19 or post-COVID-19 an increase in...

Avascular Necrosis of the Hip Joint and Femoral Head Related with Long COVID-19 or Post-COVID-19: Case Report Study

Publicado en línea: 09 abr 2024

Páginas: 291 - 297

Recibido: 29 feb 2024

Aceptado: 30 mar 2024

DOI: https://doi.org/10.3889/oamjms.2024.11889

Palabras clave
COVID-19, Long COVID, SARS Cov2, Hip, Femoral head osteonecrosis, Avascular necrosis, Hemostasis, Coagulation

© 2024 Sanja Petrusevska-Marinkovic et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License.

Avascular Necrosis of the Hip Joint and Femoral Head Related with Long COVID-19 or Post-COVID-19: Case Report Study

Publicado en línea: 09 abr 2024

Páginas: 291 - 297

Recibido: 29 feb 2024

Aceptado: 30 mar 2024

DOI: https://doi.org/10.3889/oamjms.2024.11889

Palabras claveCOVID-19, Long COVID, SARS Cov2, Hip, Femoral head osteonecrosis, Avascular necrosis, Hemostasis, Coagulation

© 2024 Sanja Petrusevska-Marinkovic et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License.

Palabras clave
COVID-19, Long COVID, SARS Cov2, Hip, Femoral head osteonecrosis, Avascular necrosis, Hemostasis, Coagulation