Avascular necrosis as sequelae of ‘long COVID-19’: A prospective study

Abstract
COVID-19, caused by SARS-CoV-2, is affecting many people worldwide. Huge numbers of people are being killed due to the virus. Although many patients are recovering from COVID-19, there may be possible complications after convalescence, including unfavorable non-pulmonary effects. One of these complications is avascular necrosis (AVN), which may lead to negative outcomes and bone collapse if missed. AVN was seen frequently in SARS and may also be common in COVID-19 infection. It should be kept in mind that the threat of AVN remains with patients recovered from COVID-19 infection, like SARS. The recent outbreak of coronavirus disease 2019 (COVID-19) has become a global pandemic. Corticosteroids have been widely used in the treatment of severe acute respiratory syndrome (SARS), and the pathological findings seen in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are very similar to those observed in severe acute respiratory syndrome-related coronavirus (SARS-CoV) infection. However, the long-term use of corticosteroids (especially at high doses) is associated with potentially serious adverse events, particularly steroid-induced avascular necrosis of the femoral head. In today's global outbreak, whether corticosteroid therapy should be used, the dosage and duration of treatment, and ways for the prevention, early detection, and timely intervention of steroid-induced avascular necrosis are some important issues that need to be addressed. This review aims to provide a reference for health care providers in COVID-19 endemic countries and regions.