During the most recent pandemy COVID-19, various advises concerning complications following high corticosteroid doses administration were pubblished in 2020. However, evidence is lacking about the incidence of Non-traumatic osteonecrosis of the femoral head (ONFH) in patients experiencing COVID-19. The aim of the present proposal is to obtain a quantitative estimation of ONFH cases among patients previoulsy hospitalized and treated for COVID-19 at ASST-Papa Giovanni XXIII.
Non-traumatic osteonecrosis of the femoral head (ONFH) is usually asimptomatic, but in advanced stages involves disabilities, leading to the lost of the joint functions. The classification of the osteonecrosis type is based on clinical and radiographical criteria. Among these, the magnetic resonance (RM) plays a crucial role for detecting lesions in the early asymptomatic phase. An high incidence of ONFH has been described during the SARS-1 pandemy: it was observed that 40% of males younger than 60, under treatment with corticosteroids, experienced it. Based on these evidences and avises concerning complications caused by intensive corticosteroid therapy during 2020, the investigators have hypothesized that the ONFH could be underestimated in patients affected by COVID-19 and that it would be diagnosed only in its advanced disabling phase. Therefore, the main aim of this investigation is to obtain an early estimation of cases experiencing ONFH through RM as long-term sequela of COVID-19, including the assessment of articular sites involved. This will be evaluated in patients hospitalized and treated for COVID-19 at ASST-Papa Giovanni XXIII between February 23, 2020 and May 21, 2020. After enrollment one visit and an instrumental assessment of hip status, including an RM and a radiography, will be scheduled in order to detect lesions at least at 1 year from previous hospitalization.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
26
After enrollment a Magnetic Resonance without medium contrast, at 1 year from previous hospitalization
ASST-Papa Giovanni XXIII
Bergamo, Lombardy, Italy
Number of patients with femoral osteonecrosis
Number of patients showing osteonecrotic lesions
Time frame: 1 year after previous hospitalization
Description of patients clinical features
Diseases and relevant clinical characteristic at the time of previous hospitalization for COVID-19
Time frame: hospitalization time 89 days
Description of COVID-19
COVID-19 outcome in term of worsening (Continuous Positive Airway Pressure - CPAP use; invasive ventilation methods) and improvement status (discharge from Intensive Care Unit -ICU; discharge from hospital)
Time frame: hospitalization time 89 days
Description of therapies employed during hospitalization
Description of therapies including oxygen based therapy, oral anticoagulants (TAO), steroid drugs and other
Time frame: hospitalization time 89 days
Definition of the stage of ONFH cases
Stage of ONFH is defined according to ARCO classification criteria
Time frame: 1 year after previous hospitalization
Number of all ON types that will be detected
ON detected in other anatomical sites will be described including proximal humerus and knee
Time frame: 1 year after previous hospitalization
To describe and define the stage of all ON cases
Stage of other ON types as assessed by ARCO classification criteria
Time frame: 1 year after previous hospitalization
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