AIIMS seeks ICMR's approval to study Covid impact on bones

AIIMS has submitted a proposal to the ICMR seeking approval for a multicentric study on the death of bone tissue among Covid patients of the second wave.

With hospitals across the country continuing to report the death of bone tissue or Avascular Necrosis (AVN) among Covid patients of the second wave mainly due to blood clots and steroid usage, All India Institute of Medical Sciences (AIIMS) has submitted a proposal to the Indian Council of Medical Research (ICMR) for getting the nod for a multicentric study on such cases.

The proposal to ICMR was submitted by Dr Rajesh Malhotra, head of orthopaedics and chief of the trauma centre at AIIMS.

AIIMS-Delhi, itself has treated more than 50 such patients. Many hospitals across Mumbai, Delhi and other cities have reported an average of 10 cases and Nanavati Hospital in Mumbai undertook the hip replacement of 10 AVN patients.

“We need to study the clinical parameters, risk factors and prognostic factors. Region-wise, the data may differ, so we want to conduct a multiple-centric study. If ICMR (approves) our proposal for the grant, they may recruit centres across India as per protocols to be part of the study,” Malhotra said, as reported by the Indian Express.

“It could be because of excessive use of steroids during Covid treatment or the inherent ability of Covid to cause blood clots, which disrupts the blood flow. Due to the excruciating pain and disability of the patient, many undergo hip replacement surgeries. Nearly 10 such AVN patients have undergone hip replacement in our hospital,” he added.

During the second wave of the Covid-19 pandemic in India, the Delta variant had caused acute pneumonia in the affected people that required heavy doses of life-saving steroids and many of such Covid survivors have now developed AVN. Out of 50 AVN cases in AIIMS, only 12 did not receive steroids during their Covid treatment. 

“We have to understand if the steroids that were given to these patients were too early or late, duration of their treatment on steroids, and the amount of doses that were given. Also, how much is too much for such patients,” Malhotra said.

“It takes months for Covid-recovered patients to develop the symptoms of AVN. Maybe after a year, with more studies, we would get a clinical explanation,” said Dr Vijay Mohan, orthopaedic and joint replacement surgeon, and chairman of the academic forum of Kerala Orthopaedic Association.

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