Covid-19感染后骨坏死的发展

G. Daltro
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引用次数: 2

摘要

新冠肺炎疫情发源于中国,已蔓延至全球,造成严重的人口和公共卫生问题。被感染者的全身病变会产生影响不同器官的级联变化。骨坏死是一种不同病因的骨病理,在世界各地都很常见,它导致髋关节致残。此外,在其病理生理中存在多基因和多因子的相互作用。本文的目的是介绍SARS-CoV-2感染后股骨头骨坏死的第一批病例,并讨论可能的病理机制。这是一个男性为主的样本,平均年龄为43.5岁,双侧髋关节受累100%的病例,从感染到出现症状的平均时间为132.8天。轻度感染后股骨头骨坏死约33%,中度或重度患者66%,使用皮质类固醇治疗,最小剂量为地塞米松40mg/天,平均时间为14.6天。我们认为,COVID-19固有的高凝机制、直接细胞感染和建立皮质治疗的关联可能是COVID-19综合征后骨坏死高发的原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Osteonecrosis Development Post Covid-19 Infection
The COVID19 pandemic, originating in China, has spread across the world, with serious proportions in populations and public health. Systemic lesions in those infected generate cascading changes affecting different organs. Osteonecrosis is a bone pathology, of different etiologies, common throughout the world, which directs the hip to a disabling condition. Furthermore, there is a polygenic and multifactorial interaction in its pathophysiology. The objective of this paper is to present the first series of cases of osteonecrosis of the femoral head after infection by SARS-CoV-2 and to discuss the possible pathological mechanisms. This is a sample with a male majority with a mean age of 43.5 years, bilateral involvement of the hip sin 100% of cases, mean time between infection and onset of symptoms was 132.8 days. About 33% had osteonecrosis of the femoral head after a mild infection, 66% were moderate or severe cases that used corticosteroid therapy with a minimum dose of 40mg/day of dexamethasone for an average time of 14.6 days. We believe that the association of hypercoagulability mechanisms inherent to COVID-19, direct cell infection and instituted cortico therapy may be responsible for the high incidence of osteonecrosis in the post-covid syndrome.
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