Symptomatic COVID-19 infections in outpatient image-guided corticosteroid injection patients during the lockdown phase.
Identifieur interne : 000E29 ( Main/Exploration ); précédent : 000E28; suivant : 000E30Symptomatic COVID-19 infections in outpatient image-guided corticosteroid injection patients during the lockdown phase.
Auteurs : Connie Y. Chang [États-Unis] ; Anand Prabhakar [États-Unis] ; Steven J. Staffa [États-Unis] ; Jad S. Husseini [États-Unis] ; Arvin B. Kheterpal [États-Unis] ; F Joseph Simeone [États-Unis] ; Miriam A. Bredella [États-Unis]Source :
- Skeletal radiology [ 1432-2161 ] ; 2020.
Abstract
BACKGROUND
Musculoskeletal pain is a debilitating problem treated with image-guided corticosteroid injections. During the COVID-19 pandemic, multiple societies issued caution statements because of the unknown effect of corticosteroids on the patient's immune system. The purpose is to determine if image-guided corticosteroid injections administered during the COVID-19 lockdown phase were associated with a higher infection rate compared to the general population.
MATERIALS AND METHODS
In a prospective study, patients undergoing image-guided corticosteroid injections for pain management during the lockdown phase between April 15 and May 22, 2020, were enrolled. One month after the injection, patients were surveyed by telephone for any COVID-19-related symptoms, and the electronic medical record (EMR) was reviewed for symptoms and test results.
RESULTS
Seventy-one subjects were recruited, 31 (44%) females, 40 (56%) males, ages 58 ± 17 (20-92) years. Follow-up was available in 66 (93%) of subjects, 60 (91%) by phone survey and EMR, 6 (9%) by EMR only, 45 ± 22 (19-83) days after injection. One (1/66, 1.52%; 95% CI 0.04-8.2%) 25-year-old male subject developed symptomatic infection 19 days after a tibiotalar injection. The prevalence of COVID-19 cases in the state of Massachusetts was 0.91% (62,726/6,892,503) during the study period. There was no significant difference in the rate of occurrence of new cases of COVID-19 infection between the corticosteroid injection group and the general population (p = 0.44).
CONCLUSION
Image-guided corticosteroid injections for pain management performed during the lockdown phase of the COVID-19 pandemic were not associated with a higher infection rate compared to the general population.
DOI: 10.1007/s00256-020-03656-w
PubMed: 33108512
PubMed Central: PMC7590247
Affiliations:
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Chang</name><affiliation wicri:level="1"><nlm:affiliation>Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA. cychang@mgh.harvard.edu.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114</wicri:regionArea><wicri:noRegion>02114</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:affiliation>Harvard Medical School, Boston, MA, USA. cychang@mgh.harvard.edu.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Prabhakar, Anand" sort="Prabhakar, Anand" uniqKey="Prabhakar A" first="Anand" last="Prabhakar">Anand Prabhakar</name><affiliation wicri:level="2"><nlm:affiliation>Department of Radiology, Newton-Wellesley Hospital, Newton, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiology, Newton-Wellesley Hospital, Newton, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="2"><nlm:affiliation>Harvard Medical School, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Staffa, Steven J" sort="Staffa, Steven J" uniqKey="Staffa S" first="Steven J" last="Staffa">Steven J. Staffa</name><affiliation wicri:level="2"><nlm:affiliation>Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="2"><nlm:affiliation>Harvard Medical School, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Husseini, Jad S" sort="Husseini, Jad S" uniqKey="Husseini J" first="Jad S" last="Husseini">Jad S. Husseini</name><affiliation wicri:level="1"><nlm:affiliation>Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114</wicri:regionArea><wicri:noRegion>02114</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:affiliation>Harvard Medical School, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Kheterpal, Arvin B" sort="Kheterpal, Arvin B" uniqKey="Kheterpal A" first="Arvin B" last="Kheterpal">Arvin B. Kheterpal</name><affiliation wicri:level="1"><nlm:affiliation>Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114</wicri:regionArea><wicri:noRegion>02114</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:affiliation>Harvard Medical School, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Simeone, F Joseph" sort="Simeone, F Joseph" uniqKey="Simeone F" first="F Joseph" last="Simeone">F Joseph Simeone</name><affiliation wicri:level="1"><nlm:affiliation>Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114</wicri:regionArea><wicri:noRegion>02114</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:affiliation>Harvard Medical School, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Bredella, Miriam A" sort="Bredella, Miriam A" uniqKey="Bredella M" first="Miriam A" last="Bredella">Miriam A. Bredella</name><affiliation wicri:level="1"><nlm:affiliation>Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114</wicri:regionArea><wicri:noRegion>02114</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:affiliation>Harvard Medical School, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author></analytic><series><title level="j">Skeletal radiology</title><idno type="eISSN">1432-2161</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Musculoskeletal pain is a debilitating problem treated with image-guided corticosteroid injections. During the COVID-19 pandemic, multiple societies issued caution statements because of the unknown effect of corticosteroids on the patient's immune system. The purpose is to determine if image-guided corticosteroid injections administered during the COVID-19 lockdown phase were associated with a higher infection rate compared to the general population.</p></div><div type="abstract" xml:lang="en"><p><b>MATERIALS AND METHODS</b></p><p>In a prospective study, patients undergoing image-guided corticosteroid injections for pain management during the lockdown phase between April 15 and May 22, 2020, were enrolled. One month after the injection, patients were surveyed by telephone for any COVID-19-related symptoms, and the electronic medical record (EMR) was reviewed for symptoms and test results.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Seventy-one subjects were recruited, 31 (44%) females, 40 (56%) males, ages 58 ± 17 (20-92) years. Follow-up was available in 66 (93%) of subjects, 60 (91%) by phone survey and EMR, 6 (9%) by EMR only, 45 ± 22 (19-83) days after injection. One (1/66, 1.52%; 95% CI 0.04-8.2%) 25-year-old male subject developed symptomatic infection 19 days after a tibiotalar injection. The prevalence of COVID-19 cases in the state of Massachusetts was 0.91% (62,726/6,892,503) during the study period. There was no significant difference in the rate of occurrence of new cases of COVID-19 infection between the corticosteroid injection group and the general population (p = 0.44).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Image-guided corticosteroid injections for pain management performed during the lockdown phase of the COVID-19 pandemic were not associated with a higher infection rate compared to the general population.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33108512</PMID><DateRevised><Year>2020</Year><Month>10</Month><Day>30</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1432-2161</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Oct</Month><Day>27</Day></PubDate></JournalIssue><Title>Skeletal radiology</Title><ISOAbbreviation>Skeletal Radiol</ISOAbbreviation></Journal><ArticleTitle>Symptomatic COVID-19 infections in outpatient image-guided corticosteroid injection patients during the lockdown phase.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1007/s00256-020-03656-w</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Musculoskeletal pain is a debilitating problem treated with image-guided corticosteroid injections. During the COVID-19 pandemic, multiple societies issued caution statements because of the unknown effect of corticosteroids on the patient's immune system. The purpose is to determine if image-guided corticosteroid injections administered during the COVID-19 lockdown phase were associated with a higher infection rate compared to the general population.</AbstractText><AbstractText Label="MATERIALS AND METHODS" NlmCategory="METHODS">In a prospective study, patients undergoing image-guided corticosteroid injections for pain management during the lockdown phase between April 15 and May 22, 2020, were enrolled. One month after the injection, patients were surveyed by telephone for any COVID-19-related symptoms, and the electronic medical record (EMR) was reviewed for symptoms and test results.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Seventy-one subjects were recruited, 31 (44%) females, 40 (56%) males, ages 58 ± 17 (20-92) years. Follow-up was available in 66 (93%) of subjects, 60 (91%) by phone survey and EMR, 6 (9%) by EMR only, 45 ± 22 (19-83) days after injection. One (1/66, 1.52%; 95% CI 0.04-8.2%) 25-year-old male subject developed symptomatic infection 19 days after a tibiotalar injection. The prevalence of COVID-19 cases in the state of Massachusetts was 0.91% (62,726/6,892,503) during the study period. There was no significant difference in the rate of occurrence of new cases of COVID-19 infection between the corticosteroid injection group and the general population (p = 0.44).</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Image-guided corticosteroid injections for pain management performed during the lockdown phase of the COVID-19 pandemic were not associated with a higher infection rate compared to the general population.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Chang</LastName><ForeName>Connie Y</ForeName><Initials>CY</Initials><Identifier Source="ORCID">http://orcid.org/0000-0003-1304-1576</Identifier><AffiliationInfo><Affiliation>Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA. cychang@mgh.harvard.edu.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Harvard Medical School, Boston, MA, USA. cychang@mgh.harvard.edu.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Prabhakar</LastName><ForeName>Anand</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Radiology, Newton-Wellesley Hospital, Newton, MA, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Harvard Medical School, Boston, MA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Staffa</LastName><ForeName>Steven J</ForeName><Initials>SJ</Initials><AffiliationInfo><Affiliation>Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Harvard Medical School, Boston, MA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Husseini</LastName><ForeName>Jad S</ForeName><Initials>JS</Initials><AffiliationInfo><Affiliation>Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Harvard Medical School, Boston, MA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kheterpal</LastName><ForeName>Arvin B</ForeName><Initials>AB</Initials><AffiliationInfo><Affiliation>Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Harvard Medical School, Boston, MA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Simeone</LastName><ForeName>F Joseph</ForeName><Initials>FJ</Initials><AffiliationInfo><Affiliation>Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Harvard Medical School, Boston, MA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bredella</LastName><ForeName>Miriam A</ForeName><Initials>MA</Initials><AffiliationInfo><Affiliation>Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Harvard Medical School, Boston, MA, USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>10</Month><Day>27</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Skeletal 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