Аваскулярный некроз эпифизов костей у пациентов, перенесших инфекцию SARS-CoV-2

Пандемия коронавирусной инфекции SARS-CoV-2 – ведущая медицинская проблема, находящаяся в центре внимания представителей всех медицинских специальностей. Помимо борьбы с самой инфекцией COVID-19, все более актуальной становится задача профилактики и лечения широкого спектра осложнений, возникающих после перенесенного заболевания. Одним из этих осложнений является аваскулярный некроз (АН) костной ткани – тяжелая патология, приводящая к серьезным страданиям, снижению качества жизни и инвалидизации пациентов. За период с 2020 по 2022 г. в мировой литературе появилось 9 обзоров, посвященных патогенезу, клиническим особенностям и возможностям терапии данного осложнения. В этот же период были опубликованы 5 статей с описанием клинических наблюдений АН после перенесенного COVID-19.
Целью настоящей работы являются демонстрация собственных клинических наблюдений, а также обзор имеющихся литературных данных по проблеме АН после перенесенной инфекции COVID-19. На основании проведенного анализа можно сделать вывод, что АН после перенесенного COVID-19 наиболее часто развивается в головке бедренной кости (>50% случаев), возникает независимо от тяжести COVID-19 и кумулятивной дозы глюкокортикоидов, использованных в остром периоде болезни. Представляется целесообразным выполнять всем пациентам, переболевшим COVID-19 в тяжелой и среднетяжелой формах, магнитно-резонансную томографию тазобедренных суставов не реже 1 раза в 3 месяца в течение первого года после реконвалесценции.

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