A Case with Avascular Bone Necrosis Developing as a Complication of COVID-19 Treatment

As our knowledge and experience of COVID-19 increases, our treatment approaches may change. For patients with respiratory failure due to COVID-19 disease, the disease table can be better controlled with systemic glucocorticoids, and mortality rates and hospitalization periods can also be reduced. Steroid therapy can be applied for the long-term, especially in cases with organized pneumonia, and patients can be discharged from hospital with maintenance treatment. Complications have been noted in patients in the post-COVID period resulting from the use of glucocorticoids. While mostly bacterial and fungal lung infections are seen, another side-effect of glucocorticoids is their negative effect on bone metabolism. We present here a case in which avascular bone necrosis developed as a result of long-term steroid use for the treatment of COVID-19.

Pulmonary embolism after COVID-19 infection in two non-hospitalized cases

SARS-CoV2 infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) may result in thrombosis development in both venous and arterial systems under the effects of inflammation increase, thrombocyte activation, endothelial dysfunction and stasis in blood flow. Accordingly, although many guidelines recommend thrombosis prophylaxis for hospitalized patients, it is not recommended for outpatients. Pulmonary embolisms were detected on computed tomography examinations performed in the emergency department in the two patients in the present study, who were being treated for coronavirus disease-19 (COVID-19) infection, but who did not require hospitalization, and who presented with complaints of shortness of breath and chest pain after treatment. We deemed it appropriate to present these cases in non-hospitalized patients to emphasize the need for thrombosis prophylaxis, considering the balance of bleeding and thrombosis.