Post-COVID steroid induced avascular necrosis of the jaw: Emerging challenge in India

The COVID-19 pandemic continues to evolve and spread with new variants of SARS-CoV-2 across the globe, as well as bring to clinical attention several post-COVID conditions. We reporta post-COVID condition observed at our tertiary care center: sponta-neous de novo development of steroid induced avascular necrosis in patients who have recently recovered from COVID-19 fol-lowing high dose steroid usage in a short span of time. Pre-COVID published literature indicates that these lesions were seen very rarely in the jaws and were related to long-term usage of steroids and recent tooth extraction. They were considered under the broad spectrum of medication-related osteonecrosis of the jaws. Present authors believe that the post-COVID-19 steroid-induced avascular necrosis of the jaws isa distinct new entity. It is analogous to the avascular necrosis noticed in the femoral head of indi-viduals recuperating from COVID-19, a condition conventionally known to be strongly associated with steroid therapy. Rapid progression, associated morbidity and mortality, and its possible differential diagnosis require pathologists to be vigilant regarding the chance encounter of such cases in jaws. Further reporting of such cases is required to gain additional insight into its features. (Oral Surg Oral Med Oral Pathol Oral Radiol 2023;135:e89-e93)

Automated summary

The COVID-19 pandemic has led to the emergence of new variants of SARS-CoV-2 and the development of several post-COVID conditions. This report describes a new post-COVID condition observed in patients who have recently recovered from COVID-19 and have received high dose steroid treatment - spontaneous de novo development of steroid induced avascular necrosis in the jaws. This condition is distinct from previously reported medication-related osteonecrosis of the jaws and further research is needed to understand its features.