What is ‘Bone Death’ Disease which has been found in COVID-19 recovered patients?

After Black Fungus or Mucormycosis that were detected in patients who recovered from COVID-19, now three patients in Mumbai have been found with Avascular Necrosis (AVN) or ‘bone death’. All three patients are below the age of 40 and currently being treated at PD Hinduja Hospital, Mumbai.

One of the medical practitioners at the Hinduja Hospital, Dr Sanjay R Agarwala said that one of the patients aged 36 was diagnosed with Avascular Necrosis (AVN) after two months of being diagnosed with COVID-19. The other two patients aged 37 and 39 were diagnosed with Avascular Necrosis (AVN) 55 and 57 days after being diagnosed with COVID-19, respectively.

What is Avascular Necrosis (AVN)?

•Avascular Necrosis (AVN), also called Osteonecrosis has been described as the death of bone tissue due to lack of blood supply that leads to tiny cracks in the bone and eventually to the collapse of the bone.

•The condition is mostly found in the hip joint. It may also lead to painful arthritis. Usually, people aged between 30 and 50 years are found to be suffering from it.

Avascular Necrosis (AVN): Symptoms

•In the early stages, there are no symptoms other than pain and stiffness in joints. Gradually, it becomes severe. People experiencing pain in the thigh, groin, or buttock region are advised to check with a doctor as these could be underlying symptoms of Avascular Necrosis (AVN) in the hip region.

•Other than the hip region, the knee, foot, hand, and shoulder are also some regions that are vulnerable to AVN.

Avascular Necrosis (AVN): Causes

•Avascular Necrosis (AVN) or Osteonecrosis is caused when blood flow to a bone is reduced or interrupted. Lack of blood supply to a bone can be caused by fatty deposits in blood vessels, joint or bone injury, or damaged blood vessels.

•In the case of patients who recovered from COVID-19, doctors have expressed that the use of steroids during COVID-19 therapies is a likely cause of AVN. High doses of corticosteroids like prednisone can lead to an increase in lipid levels in the blood thus disrupting blood flow.

•Apart from COVID-19, experts have also stated that cancer treatments involving radiation can also damage blood vessels and weaken bone structure. Other medical conditions such as anemia or sickle cell or Gaucher’s disease can also interrupt or reduce blood flow to bones.

•Medications for increasing bone density have also been found to cause AVN, especially in the jaw.

•Fat deposits due to excessive drinking over a long period are also linked with AVN as heavy drinking enables the formation of fat deposits in blood vessels.