What is 'bone death'? Know all about Avascular Necrosis (AVN) affecting COVID-19 survivors

COVID-19 pandemic which has wreaked havoc across the world also gave rise to cases of Mucormycosis or the Black Fungus in India as the people who underwent the treatment for COVID-19 also saw Mucormycosis as a fallout of the treatment. However, now another post COVID disorder called Avascular necrosis (AVN) also called as the death of bone tissues or 'Bone Death' has been witnessed among those taking treatment for COVID-19.

According to media reports, three cases of Bone Death have been reported in Mumbai with doctors fearing there could be a rise in such cases in the coming months.

What is Avascular Necrosis aka death of bone tissue or Bone Death?

Avascular necrosis is the death of bone tissue due to a lack of blood supply. It can lead to tiny breaks in the bone and the bone's eventual collapse. A broken bone or dislocated joint can interrupt the blood flow to a section of bone. Avascular necrosis is also associated with long-term use of high-dose steroid medications and excessive alcohol intake. Anyone can be affected by it but this condition is most common in people between 30 to 50 years of age.

People generally have no early symptoms but as the condition worsens, people might feel pain in their joints when they exert little pressure or weight on their joints. The pain gradually increases even when the person is not exerting pressure or weight on his/her joints. Pains can be experienced in body parts such as hips, shoulders, knees, hands and feet.

Three cases of Bone death in Mumbai after COVID-19

Hinduja Hospital has shed light on the occurrence of AVN among three of its patients, two months after they were treated with COVID-19. Patients in all three cases were under 40 years of age, raising concerns that the younger population suffering severe COVID-19 could be affected by Bone death.

Hinduja Hospital's medical director Sanjay Agarwala published a paper in the medical journal BMJ Case Studies in which he detailed the course of AVN diagnosis in the three patients. He mentioned that the three patients were administered intravenous steroids as a part of the treatment for COVID-19. The patients are aged 36, 37 and 39, and the AVN was diagnosed 67 days, 55 days and 57 days after their diagnosis of COVID-19 respectively.

He highlighted that under normal circumstances, it usually takes six months to a year to develop AVN after steroid usage, however, in COVID cases, AVN was diagnosed within two months after their diagnosis of COVID-19.