Providing Steroid/Corticosteroid Injections Safely in the COVID-19 Environment

Hackett, Beth Ann

doi:10.1016/j.jradnu.2020.04.008

Cited by 2 publications

(1 citation statement)

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“…Given that a single dose of ICI reduces systemic blood lymphocyte count, leading to lymphopenia four hours after injection [ 52 ], ICIs may impair the host protective response against SARS-CoV-2. The systemic and immunosuppressive effects of steroid injections may last several weeks [ 72 ] and could consequentially expose patients to COVID-19 infection and developing severe disease. Accordingly, ICIs increases the risk of influenza even among vaccinated individuals [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Perioperative use of intra-articular steroids during the COVID-19 pandemic

Jou

Zhou

et al. 2021

Eur J Orthop Surg Traumatol

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Purpose There are growing concerns with the widely used glucocorticoids during the Coronavirus disease-19 (COVID-19) pandemic due to the associated immunosuppressive effects, which may increase the risk of COVID-19 infection and worsen COVID-19 patient outcome. Heavily affecting orthopaedics, the pandemic led to delay and cancellation of almost all surgical cases, and procedures including perioperative intra-articular corticosteroid injections (ICIs) saw similar decreases. However, the benefits of ICI treatments during the pandemic may outweigh these potential risks, and their continued use may be warranted. Methods A literature search was conducted, and all relevant articles including original articles and reviews were identified and considered in full for inclusion, and analysed with expert opinion. Epidemiological statistics and medical guidelines were consulted from relevant authorities. Results ICIs allow a targeted approach on the affected joint and are effective in reducing pain while improving functional outcome and patient quality-of-life. ICIs delay the requirement for surgery, accommodating for the increased healthcare burden during the pandemic, while reducing postoperative hospital stay, bringing significant financial benefits. However, ICIs can exert systemic effects and suppress the immune system. ICIs may increase the risk of COVID-19 infection and reduce the efficacy of COVID-19 vaccinations, leading to important public health implications. Conclusion Perioperative ICI treatments may bring significant, multifaceted benefits during the pandemic. However, ICIs increase the risk of infection, and perioperative COVID-19 is associated with mortality. The use of ICIs during the COVID-19 pandemic should therefore be considered carefully on an individual patient basis, weighing the associated risks and benefits.

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Section: Introductionmentioning

confidence: 99%