Steroid abuse & coronavirus: Rise in bone-related ailments in former Covid patients

Hyderabad: Unrestricted consumption of steroids by those affected with Covid-19 has led to a sharp increase in the death of bone tissues, especially in the hip joints. These are cases of avascular necrosis (AVN) of hip and it can lead to difficulty in walking and also activities of daily life if not treated.

Post-pandemic, there are people in the age-group of 20 to 30 years who are reporting these problems.

Pre-Covid, the problem of avascular necrosis was noted in those suffering from severe arthritis and high cholesterol, those consuming steroids, and heavy smokers and alcoholics.

Abuse of steroids during Covid-19

There is a 20-30% spike in cases of avascular necrosis of the hip in those who suffered from Covid-19. Many patients were given steroids in hospitals, while others opted for unsupervised steroid consumption to cure themselves.

Indiscriminate use of steroids leads to loss of blood supply to the bone and eventually, death of the tissue.

In some patients, abuse of steroids for a few months or self-prescribing a combination of steroids to cure Covid-19 has led to this condition.

There are also people who had various mixtures where it is suspected that steroids were added for "better immunity." These cases are now surfacing in clinics and hospitals where not only the hip bones but surrounding bones are also affected. There is also femoral loss which is a very advanced stage and can lead to disability.

Dr. K.J Reddy, a senior consultant and orthopedic surgeon at Apollo Hospitals, explains, "Pain is the only symptom of this condition. Pain while walking, getting up, and doing activities that require the joints to bend but cannot be done smoothly is the indication. Acute and unbearable pain is when the deterioration is at an advanced stage. Diagnosis is through x-ray and MRI which indicates the stage of deterioration."

If the deterioration is very high, then surgical treatments are required.

Dr. Reddy adds, "In core decompression with bone implantation using stem cell therapy has also been successful. In the late stages where the hip joint cannot be preserved, a total hip replacement is required."

· Early diagnosis, medication, and therapy involve bed rest, the use of blood thinners and bisphosphonates.

· Intermediate stage benefits from core decomposition and stem cell treatment.

· The last stage requires total hip replacement.

For those who self-medicated, it is important to take preventive measures:

· Keep cholesterol levels low.

· Fat is the most common substance in the body that blocks blood to the bones so it is important that they check their body weight.

· Do not take steroids, especially those working out in the gym.

· Limit alcohol intake.

Loss of livelihood due to AVN

After the pandemic, the impact of AVN is being seen in the earning members of the family due to which families are facing financial crises. Senior orthopaedic surgeons in the city state that this degeneration was multi-factorial but present cases show a history of steroid abuse only.

With the rampant abuse of steroids, it has taken a toll on the productive age group and the after-effects are being seen now.

Many patients do not have the resources for surgery and that is one of the reasons they come late to hospitals.

Many have been fighting the problem, hoping it will resolve but are now crippled and have lost their jobs, leading to a financial crisis.