1
|
Hogea B, Suba MI, Abu-Awwad SA, Cuntan P, Popa MV, Braescu RD, Abu-Awwad A. Exploring the Association between COVID-19 and Femoral Head Necrosis: A Comprehensive Review. Life (Basel) 2024; 14:671. [PMID: 38929655 PMCID: PMC11204444 DOI: 10.3390/life14060671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 05/18/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024] Open
Abstract
This study investigates the correlation between COVID-19 and avascular necrosis of the femoral head, considering the potential contribution of medication-induced effects. This research spans the period from August 2022 to January 2024 and includes 32 patients diagnosed with avascular necrosis. While steroid usage, particularly in high doses, is known to predispose individuals to this condition, this study aims to discern if COVID-19 itself plays a role beyond the influence of medication. Notably, COVID-19 is associated with disturbances in the coagulation system, potentially leading to thromboembolic complications. Of the patients, six did not have COVID-19, while seven had the virus but did not receive steroid treatment. However, 19 patients with COVID-19 exhibited severe pulmonary involvement and were administered both high-dose steroids and antiviral medication. Among the observed patients, 14 were female and 18 were male. Notably, three patients presented bilateral necrosis, all of whom had COVID-19 and significant pulmonary involvement. Diagnostic assessments included frontal and profile X-rays, as well as MRI scans for all patients.
Collapse
Affiliation(s)
- Bogdan Hogea
- Department XV—Discipline of Orthopedics—Traumatology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (B.H.); (A.A.-A.)
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania; (S.-A.A.-A.); (P.C.); (M.-V.P.); (R.D.B.)
- Research Center University Professor Doctor Teodor Șora, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Madalina-Ianca Suba
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Dr. Victor Babeș Infectious Diseases and Pneumophthisiology Hospital Timisoara, 300310 Timisoara, Romania
| | - Simona-Alina Abu-Awwad
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania; (S.-A.A.-A.); (P.C.); (M.-V.P.); (R.D.B.)
- Department XII—Discipline of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Paul Cuntan
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania; (S.-A.A.-A.); (P.C.); (M.-V.P.); (R.D.B.)
| | - Mihai-Valetin Popa
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania; (S.-A.A.-A.); (P.C.); (M.-V.P.); (R.D.B.)
| | - Ruben David Braescu
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania; (S.-A.A.-A.); (P.C.); (M.-V.P.); (R.D.B.)
| | - Ahmed Abu-Awwad
- Department XV—Discipline of Orthopedics—Traumatology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (B.H.); (A.A.-A.)
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania; (S.-A.A.-A.); (P.C.); (M.-V.P.); (R.D.B.)
- Research Center University Professor Doctor Teodor Șora, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| |
Collapse
|
2
|
Sakellariou E, Argyropoulou E, Karampinas P, Galanis A, Varsamos I, Giannatos V, Vasiliadis E, Kaspiris A, Vlamis J, Pneumaticos S. A Comprehensive Review of COVID-19-Infection- and Steroid-Treatment-Associated Bone Avascular Necrosis: A Multi-Study Analysis. Diagnostics (Basel) 2024; 14:247. [PMID: 38337763 PMCID: PMC10855439 DOI: 10.3390/diagnostics14030247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has presented numerous challenges to the global healthcare system and emerging evidence suggests a potential link between COVID-19 treatment, specifically steroid therapy, and the development of avascular necrosis (AVN) of the hip. This review aims to provide a comprehensive overview of recent studies and case reports investigating the relationship between COVID-19, corticosteroid therapy, and the development of AVN. Understanding the nuances of AVN in the context of COVID-19 is crucial for healthcare professionals to navigate treatment decisions and mitigate potential complications. MATERIALS AND METHODS The Preferred Reporting Items for Systematic Reviews and a Meta-Analysis (PRISMA) were used in the systematic review until 1 September 2023. The full texts of the remaining twenty-three (n = 23) articles were independently reviewed by the authors of this review. CONCLUSIONS The association between steroid therapy for COVID-19 and the development of hip AVN is a noteworthy concern even though no relationship is evident between the duration of treatment, cumulative dosage of medication, maximum daily dosage received, and presence of AVN. Further research with larger cohorts and long-term follow up is needed to better understand the causative relationship and optimal management strategies for hip AVN in the context of COVID-19 and steroid therapy.
Collapse
Affiliation(s)
- Evangelos Sakellariou
- Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, 14561 Athens, Greece; (E.S.); (P.K.); (A.G.); (I.V.); (E.V.); (A.K.); (J.V.); (S.P.)
| | - Evangelia Argyropoulou
- Department of Orthopaedics and Traumatology, University General Hospital of Patras, 26504 Patras, Greece;
| | - Panagiotis Karampinas
- Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, 14561 Athens, Greece; (E.S.); (P.K.); (A.G.); (I.V.); (E.V.); (A.K.); (J.V.); (S.P.)
| | - Athanasios Galanis
- Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, 14561 Athens, Greece; (E.S.); (P.K.); (A.G.); (I.V.); (E.V.); (A.K.); (J.V.); (S.P.)
| | - Iordanis Varsamos
- Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, 14561 Athens, Greece; (E.S.); (P.K.); (A.G.); (I.V.); (E.V.); (A.K.); (J.V.); (S.P.)
| | - Vasileios Giannatos
- Department of Orthopaedics and Traumatology, University General Hospital of Patras, 26504 Patras, Greece;
| | - Elias Vasiliadis
- Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, 14561 Athens, Greece; (E.S.); (P.K.); (A.G.); (I.V.); (E.V.); (A.K.); (J.V.); (S.P.)
| | - Angelos Kaspiris
- Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, 14561 Athens, Greece; (E.S.); (P.K.); (A.G.); (I.V.); (E.V.); (A.K.); (J.V.); (S.P.)
| | - John Vlamis
- Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, 14561 Athens, Greece; (E.S.); (P.K.); (A.G.); (I.V.); (E.V.); (A.K.); (J.V.); (S.P.)
| | - Spiros Pneumaticos
- Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, 14561 Athens, Greece; (E.S.); (P.K.); (A.G.); (I.V.); (E.V.); (A.K.); (J.V.); (S.P.)
| |
Collapse
|
3
|
Elbialy A, Megahed MME, Ibrahim AS, Elmesiry AM, Mohamed MSE, Ghit MM, Gazar YAM, Elazab SA. Bilateral Avascular Necrosis of the Femoral Heads After COVID-19 Infection without Steroid Treatment. Curr Rheumatol Rev 2024; 20:465-468. [PMID: 37870059 DOI: 10.2174/0115733971259997231012101534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/18/2023] [Accepted: 09/14/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Avascular necrosis (AVN) is a potentially serious multifactorial disease. In COVID-19 patients, AVN of many bones has been reported. Usually, the condition is linked to steroid therapy. In this case report, we describe our experience with bilateral AVN of femoral heads in an elderly patient months after being cured of COVID-19 infection without the use of steroids. CASE PRESENTATION A 68-year-old male was referred to the outpatient clinic of the rheumatology and rehabilitation department for progressive bilateral hip pain starting on the left side 5 months ago. An extensive review of the patient's medical history identified documented COVID-19 infection that required hospitalization 9 months before presentation. Multiplanar MRI with fat suppression of both hips showed ill-defined areas of abnormal signal intensity affecting the left femoral head, neck and intertrochanteric regions with associated subchondral fissuring and mild joint effusion. A similar smaller area was also seen affecting the postero-superior aspect of the right femoral head. CONCLUSION AVN in COVID-19 patients can be encountered even in the absence of steroid therapy.
Collapse
Affiliation(s)
- Adel Elbialy
- Department of Rheumatology and Rehabilitation, Al-Azhar University, Cairo, Egypt
| | | | - Amira Shahin Ibrahim
- Department of Rheumatology and Rehabilitation, Al-Azhar University, Cairo, Egypt
| | - Aml Mohamed Elmesiry
- Department of Rheumatology and Rehabilitation, Al-Azhar University, Cairo, Egypt
| | | | - Mohamed Magdy Ghit
- Department of Rheumatology and Rehabilitation, Al-Azhar University, Cairo, Egypt
| | | | | |
Collapse
|
4
|
Saklecha A, Harjpal P, Dadgal R. Physiotherapy Rehabilitation Towards Foot Drop in a Paediatric Case of Iatrogenic Sciatic Nerve Palsy: A Case Report. Cureus 2024; 16:e51771. [PMID: 38322068 PMCID: PMC10844766 DOI: 10.7759/cureus.51771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/06/2024] [Indexed: 02/08/2024] Open
Abstract
In this report, we are presenting a case of injection nerve palsy in a three-year-old child whose parents visited with the complaint of weakness of the left lower limb, inability to walk, and difficulty in performing lower limb movements after taking diphtheria-tetanus-pertussis (DPT) vaccination in the gluteal region by intramuscular route. The child exhibited a foot drop on his left leg and a high step gait when examined. Nerve conduction velocity was performed, which revealed pure motor axonal mononeuropathy involving the left sciatic nerve. She was diagnosed with a left sciatic nerve injury from a foot drop and was referred to physiotherapy. With the proper exercise protocol, physiotherapy rehabilitation began. We report that after rehabilitation, she showed improvement in the strength of the lower limb and gait pattern. As a result, physiotherapy is critical in improving a patient's gait pattern, ensuring early and rapid recovery, and treating the condition's clinical manifestations. This case study concludes that physiotherapy rehabilitation for injection palsy in a three-year-old female child with foot drop led to improved lower-limb strength, which assisted the patient in ambulation and prevented other deformities.
Collapse
Affiliation(s)
- Akshaya Saklecha
- Department of Neuro Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pallavi Harjpal
- Department of Neuro Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ragini Dadgal
- Department of Neuro Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
5
|
Grillo R, Samieirad S, Alizadeh O, Hosseini Zarch SH, Khodashahi R, Kazemian N, Naclério-Homem MDG. Two Cases of COVID-Related Osteonecrosis of the Jaws: A New and Worrying Entity Is Emerging. World J Plast Surg 2024; 13:96-102. [PMID: 38742034 PMCID: PMC11088725 DOI: 10.61186/wjps.13.1.96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/21/2024] [Indexed: 05/16/2024] Open
Abstract
Many people were affected by COVID-19 in its severe form. Some intercurrences are still emerging. We here report two cases of COVID-related osteonecrosis of the jaws (CRONJ). Two retrospective cases were admitted into Imam Reza Hospital, Mashhad, Iran with suspected CRONJ. One patient escaped from hospital while the other showed a positive result after our proposed treatment. A new aftermath to COVID-19 infections is emerging. Maxillofacial and orthopedic surgeons should be aware of this situation. CRONJ should be on the suspect list in patients with COVID-19. Measures that are useful in the treatment carried out, as well as some measures recommended in the literature, were discussed. Surgical treatment of CRONJ appears to be an effective alternative, especially in the more aggressive cases.
Collapse
Affiliation(s)
- Ricardo Grillo
- Department of Oral & Maxillofacial Surgery, Traumatology and Prosthesis – Faculty of Dentistry of the University of São Paulo, Brazil
| | - Sahand Samieirad
- Department of Oral & Maxillofacial Surgery, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Omid Alizadeh
- Student Research Committee, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Hossein Hosseini Zarch
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Rozita Khodashahi
- Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Navid Kazemian
- Dental Research Center, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maria da Graça Naclério-Homem
- Department of Oral & Maxillofacial Surgery, Traumatology and Prosthesis – Faculty of Dentistry of the University of São Paulo, Brazil
| |
Collapse
|
6
|
Okewunmi JO, Duey AH, Zubizarreta N, Kodali H, Poeran J, Hayden BL, Moucha CS, Chen DD. Did the COVID-19 Pandemic Coincide With an Increase in Osteonecrosis as Indication for Total Hip Arthroplasty in Older Patients? J Arthroplasty 2023; 38:2634-2637. [PMID: 37315633 PMCID: PMC10260267 DOI: 10.1016/j.arth.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/31/2023] [Accepted: 06/03/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Osteonecrosis of the femoral head is a common indication for total hip arthroplasty (THA). It is unclear to what extent the COVID-19 pandemic has impacted its incidence. Theoretically, the combination of microvascular thromboses and corticosteroid use in patients who have COVID-19 may increase the risk of osteonecrosis. We aimed to (1) assess recent osteonecrosis trends and (2) investigate if a history of COVID-19 diagnosis is associated with osteonecrosis. METHODS This retrospective cohort study utilized a large national database between 2016 and 2021. Osteonecrosis incidence in 2016 to 2019 was compared to 2020 to 2021. Secondly, utilizing a cohort from April 2020 through December 2021, we investigated whether a prior COVID-19 diagnosis was associated with osteonecrosis. For both comparisons, Chi-square tests were applied. RESULTS Among 1,127,796 THAs performed between 2016 and 2021, we found an osteonecrosis incidence of 1.6% (n = 5,812) in 2020 to 2021 compared to 1.4% (n = 10,974) in 2016 to 2019; P < .0001. Furthermore, using April 2020 to December 2021 data from 248,183 THAs, we found that osteonecrosis was more common among those who had a history of COVID-19 (3.9%; 130 of 3,313) compared to patients who had no COVID-19 history (3.0%; 7,266 of 244,870); P = .001). CONCLUSION Osteonecrosis incidence was higher in 2020 to 2021 compared to previous years and a previous COVID-19 diagnosis was associated with a greater likelihood of osteonecrosis. These findings suggest a role of the COVID-19 pandemic on an increased osteonecrosis incidence. Continued monitoring is necessary to fully understand the impact of the COVID-19 pandemic on THA care and outcomes.
Collapse
Affiliation(s)
- Jeffrey O Okewunmi
- Department of Orthopaedic Surgery, Brown University, Providence, Rhode Island; Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Akiro H Duey
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nicole Zubizarreta
- Department of Population Health Science and Policy, Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Hanish Kodali
- Department of Population Health Science and Policy, Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jashvant Poeran
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Population Health Science and Policy, Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Brett L Hayden
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Calin S Moucha
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Darwin D Chen
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| |
Collapse
|
7
|
Hassan AAA, Khalifa AA. Femoral head avascular necrosis in COVID-19 survivors: a systematic review. Rheumatol Int 2023; 43:1583-1595. [PMID: 37338665 PMCID: PMC10348993 DOI: 10.1007/s00296-023-05373-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 06/13/2023] [Indexed: 06/21/2023]
Abstract
The current systematic review aimed to document published cases of femoral head avascular necrosis (FHAVN) post-COVID-19, to report the COVID-19 disease characteristics and management patients received, and to evaluate how the FHAVN were diagnosed and treated among various reports. A systematic literature review was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines through a comprehensive English literature search on January 2023 through four databases (Embase, PubMed, Cochrane Library, and Scopus), including studies reporting on FHAVN post-COVID-19. Fourteen articles were included, ten (71.4%) were case reports, and four (28.6%) case series reported on 104 patients having a mean age of 42.2 ± 11.7 (14:74) years, in which 182 hip joints were affected. In 13 reports, corticosteroids were used during the COVID-19 management plan for a mean of 24.8 ± 11 (7:42) days, with a mean prednisolone equivalent dose of 1238.5 ± 492.8 (100:3520) mg. A mean of 142.1 ± 107.6 (7:459) days passed between COVID-19 diagnosis and FHAVN detection, and most of the hips were stage II (70.1%), and concomitant septic arthritis was present in eight (4.4%) hips. Most hips (147, 80.8%) were treated non-surgically, of which 143 (78.6%) hips received medical treatment, while 35 (19.2%) hips were surgically managed, 16 (8.8%) core decompression, 13 (7.1%) primary THA, five (2.7%) staged THA and three (1.6%) had first stage THA (debridement and application of antibiotic-loaded cement spacer). The outcomes were acceptable as regards hip function and pain relief. Femoral head avascular necrosis post-COVID-19 infection is a real concern, primarily attributed to corticosteroid usage, besides other factors. Early suspicion and detection are mandatory, as conservative management lines are effective during early stages with acceptable outcomes. However, surgical intervention was required for progressive collapse or patients presented in the late stage.
Collapse
Affiliation(s)
| | - Ahmed A. Khalifa
- Orthopedic Department, Qena Faculty of Medicine, South Valley University, Kilo 6 Qena-Safaga Highway, Qena, Egypt
| |
Collapse
|
8
|
Ciaffi J, Vanni E, Mancarella L, Brusi V, Lisi L, Pignatti F, Naldi S, Assirelli E, Neri S, Reta M, Faldini C, Ursini F. Post-Acute COVID-19 Joint Pain and New Onset of Rheumatic Musculoskeletal Diseases: A Systematic Review. Diagnostics (Basel) 2023; 13:diagnostics13111850. [PMID: 37296705 DOI: 10.3390/diagnostics13111850] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/20/2023] [Accepted: 05/20/2023] [Indexed: 06/12/2023] Open
Abstract
As the number of reports of post-acute COVID-19 musculoskeletal manifestations is rapidly rising, it is important to summarize the current available literature in order to shed light on this new and not fully understood phenomenon. Therefore, we conducted a systematic review to provide an updated picture of post-acute COVID-19 musculoskeletal manifestations of potential rheumatological interest, with a particular focus on joint pain, new onset of rheumatic musculoskeletal diseases and presence of autoantibodies related to inflammatory arthritis such as rheumatoid factor and anti-citrullinated protein antibodies. We included 54 original papers in our systematic review. The prevalence of arthralgia was found to range from 2% to 65% within a time frame varying from 4 weeks to 12 months after acute SARS-CoV-2 infection. Inflammatory arthritis was also reported with various clinical phenotypes such as symmetrical polyarthritis with RA-like pattern similar to other prototypical viral arthritis, polymyalgia-like symptoms, or acute monoarthritis and oligoarthritis of large joints resembling reactive arthritis. Moreover, high figures of post-COVID-19 patients fulfilling the classification criteria for fibromyalgia were found, ranging from 31% to 40%. Finally, the available literature about prevalence of rheumatoid factor and anti-citrullinated protein antibodies was largely inconsistent. In conclusion, manifestations of rheumatological interest such as joint pain, new-onset inflammatory arthritis and fibromyalgia are frequently reported after COVID-19, highlighting the potential role of SARS-CoV-2 as a trigger for the development of autoimmune conditions and rheumatic musculoskeletal diseases.
Collapse
Affiliation(s)
- Jacopo Ciaffi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Elena Vanni
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Luana Mancarella
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Veronica Brusi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Lucia Lisi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Federica Pignatti
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Susanna Naldi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Elisa Assirelli
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Simona Neri
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Massimo Reta
- UO Interaziendale Medicina Interna ad Indirizzo Reumatologico (SC) AUSL BO-IRCCS AOU BO, 40133 Bologna, Italy
| | - Cesare Faldini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40126 Bologna, Italy
- 1st Orthopedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Francesco Ursini
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40126 Bologna, Italy
| |
Collapse
|