General recommendation for assessment and management on the risk of glucocorticoid-induced osteonecrosis in patients with COVID-19

Li, Wenlong; Huang, Zhiqiang; Tan, Biao; Chen, Gang; Li, Xugui; Xiong, Kan; Zhu, Ruizheng; Li, Ruihan; Li, Shuwen; Ye, Hengli; Liang, Zhi; Dong, Xiaojun; Zhou, Shijing; Song, Chunyan; Xi, Haixiang; Cheng, Hao; Xu, Rongpeng; Tu, Shenghao; Chen, Zhe; Qi, Lihua; Song, Jiandong; Xiao, Ruoran; Liu, Huilan; Nan, Qian; Yu, Huilin; Cui, Hongsheng; Shen, Yanguang; Wang, Cheng-Xiang; Lin, Na; Zhang, Yanqiong; Chen, Weiheng

doi:10.1016/j.jot.2021.09.005

Cited by 22 publications

(45 citation statements)

References 32 publications

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“…31 CS usage has recently increased worldwide because of its role in the treatment of patients with severe coronavirus disease 2019 (COVID-19). 30 Li et al 51 reported that the incidence of osteonecrosis among patients with severe acute respiratory syndrome who received high cumulative doses and long treatment durations of glucocorticoids was 32%. Considering the similarity between severe acute respiratory syndrome and COVID-19 and the fact that osteonecrosis has already been reported after COVID-19 and CS treatment, 51 clinicians must be aware of this condition in convalescent COVID-19 patients with shoulder symptoms who received CS treatment.…”

Section: Corticosteroid Use and Osteonecrosismentioning

confidence: 99%

Atraumatic osteonecrosis of the humeral head: pathophysiology and current concepts of evaluation and treatment

Mercado

Rojas

Zaldivar

et al. 2022

JSES Reviews, Reports, and Techniques

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Section: Corticosteroid Use and Osteonecrosismentioning

confidence: 99%

Atraumatic osteonecrosis of the humeral head: pathophysiology and current concepts of evaluation and treatment

Mercado

Rojas

Zaldivar

et al. 2022

JSES Reviews, Reports, and Techniques

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“…Причин для возникновения остеонекроза после перенесенной коронавирусной инфекции и возникающего вследствие этого суставного синдрома множество: кроме системного воспалительного ответа, это и гиперкоагуляция [29], и перенесенный острый респираторный дистресс-синдром, и лечение ГК [30,31]. В большинстве случаев поражается головка бедренной кости, дистальный эпифиз бедренной и большеберцовой костей, головка плечевой кости, реже -таранная кость, пяточная кость и другие анатомические области [27].…”

Section: механизмы артралгии и миалгии при коронавирусной инфекцииunclassified

Musculoskeletal manifectations of the new coronavirus infection: focus on arthralgia and myalgia

Клименко

Демидова

et al. 2022

Klinicist

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The new coronavirus infection (COVID-19) is associated with a wide spectrum of various clinical manifestations including involvement of the musculoskeletal system which can persist for a long time after the infection. Supposedly, pathogenesis of musculoskeletal manifestations of COVID-19 is primarily caused by systemic inflammation accompanied by cytokine hyperexpression (interferon γ, interleukins 1β, 6, 8, 17, tumor necrosis factor α), as well as hypoxia leading to overproduction of inflammatory cytokines, activation of bone reabsorption by osteoclasts and subsequent decrease of mineral bone density and osteonecrosis in some cases. Additionally, some drugs prescribed to patients with COVID-19 (some antiviral drugs and glucocorticoids) should also be taken into account as they can lead to development of musculoskeletal pathology. In the acute period of COVID-19, myalgias are common, but in rare cases myositis with proximal muscular weakness and increased levels of creatine phosphokinase, lactate dehydrogenase can occur. Arthralgias in the acute period of COVID-19 are rarer than myalgias. In the studies of clinical manifestation of COVID-19, frequency of arthralgias and myalgias in the acute period is between 15.5 and 50 %. After COVID-19, frequency of arthralgias and myalgias gradually decreases, however there are cases of long-term joint and muscle pains, as well as post-viral arthritis, development of arthritis in the context of various autoimmune disorders. Myalgias and arthralgias during COVID-19 usually regress spontaneously and in most patients do not require prescription of antipain medications, but in some cases pain management is necessary. Use of non-steroid anti-inflammatory drugs and vitamin D during COVID-19 is a safe and effective method of pain management, including myalgia and arthralgia. Rehabilitation programs play an important role in improvement of functional state and patient recovery after moderate and severe COVID-19.

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“…Glucocorticoids by altering the bone metabolism shift the balance of bone remodeling towards OCs thus enhancing bone loss. Recently, a cross-sectional study reported a confirmed case of osteonecrosis in a cohort of Wuhan COVID-19 patients treated with glucocorticoids [ 34 , 35 ]. Moreover, dexamethasone via inhibiting the osteogenesis of stem cells reduced the ability of cells to repair the bone and thus lead to the onset of osteonecrosis.…”

Section: Introductionmentioning

confidence: 99%

Long-term implications of COVID-19 on bone health: pathophysiology and therapeutics

et al. 2022

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Background SARS-CoV-2 is a highly infectious respiratory virus associated with coronavirus disease (COVID-19). Discoveries in the field revealed that inflammatory conditions exert a negative impact on bone metabolism; however, only limited studies reported the consequences of SARS-CoV-2 infection on skeletal homeostasis. Inflammatory immune cells (T helper—Th17 cells and macrophages) and their signature cytokines such as interleukin (IL)-6, IL-17, and tumor necrosis factor-alpha (TNF-α) are the major contributors to the cytokine storm observed in COVID-19 disease. Our group along with others has proven that an enhanced population of both inflammatory innate (Dendritic cells—DCs, macrophages, etc.) and adaptive (Th1, Th17, etc.) immune cells, along with their signature cytokines (IL-17, TNF-α, IFN-γ, IL-6, etc.), are associated with various inflammatory bone loss conditions. Moreover, several pieces of evidence suggest that SARS-CoV-2 infects various organs of the body via angiotensin-converting enzyme 2 (ACE2) receptors including bone cells (osteoblasts—OBs and osteoclasts—OCs). This evidence thus clearly highlights both the direct and indirect impact of SARS-CoV-2 on the physiological bone remodeling process. Moreover, data from the previous SARS-CoV outbreak in 2002–2004 revealed the long-term negative impact (decreased bone mineral density—BMDs) of these infections on bone health. Methodology We used the keywords “immunopathogenesis of SARS-CoV-2,” “SARS-CoV-2 and bone cells,” “factors influencing bone health and COVID-19,” “GUT microbiota,” and “COVID-19 and Bone health” to integrate the topics for making this review article by searching the following electronic databases: PubMed, Google Scholar, and Scopus. Conclusion Current evidence and reports indicate the direct relation between SARS-CoV-2 infection and bone health and thus warrant future research in this field. It would be imperative to assess the post-COVID-19 fracture risk of SARS-CoV-2-infected individuals by simultaneously monitoring them for bone metabolism/biochemical markers. Importantly, several emerging research suggest that dysbiosis of the gut microbiota—GM (established role in inflammatory bone loss conditions) is further involved in the severity of COVID-19 disease. In the present review, we thus also highlight the importance of dietary interventions including probiotics (modulating dysbiotic GM) as an adjunct therapeutic alternative in the treatment and management of long-term consequences of COVID-19 on bone health.

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General recommendation for assessment and management on the risk of glucocorticoid-induced osteonecrosis in patients with COVID-19

Cited by 22 publications

References 32 publications

Atraumatic osteonecrosis of the humeral head: pathophysiology and current concepts of evaluation and treatment

Atraumatic osteonecrosis of the humeral head: pathophysiology and current concepts of evaluation and treatment

Musculoskeletal manifectations of the new coronavirus infection: focus on arthralgia and myalgia

Long-term implications of COVID-19 on bone health: pathophysiology and therapeutics

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