Exploring the Association Between COVID-19 and Avascular Necrosis: A Systematic Review
Bibliographic record
Abstract
Avascular necrosis (AVN) has emerged as an extrapulmonary complication associated with COVID-19 and corticosteroids. This review aims to evaluate the association between COVID-19 infection, corticosteroid use, and the development of AVN. We conducted a systematic review following the PRISMA guidelines, searching five databases until May 30, 2024. We included cohort and case series studies involving COVID-19 patients who developed AVN. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). A total of 13 studies, comprising nine case series and four cohort studies, were included. These studies involved 795 patients with a mean age of 46.1 years and a male predominance (66%). The cumulative dose of corticosteroids varied, with an average of 1,462.9 mg. The duration between COVID-19 infection and initial AVN symptoms ranged from 2 to 62 weeks. The most commonly affected bones were the hip and femoral head. The visual analog scale (VAS) score improved with the treatment, and the cases showed improvements. A significant association was found between COVID-19, corticosteroid use, and AVN development. Clinicians should exercise caution when prescribing corticosteroids and monitor for early signs of AVN. Further research is needed to elucidate the pathophysiological mechanisms and explore alternative treatments to mitigate the risk of AVN.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".