During these challenging times ACPOMIT will endeavour to support injecting Physiotherapists by reviewing and posting the literature relating to use of corticosteroid injections during the COVID-19 pandemic. We will also offer recommendations on the considerations to make for returning to a face-face service in forth coming months.
Patients who recieve a steroid injection during the COVID-19 pandemic may be at increase the risk of an adverse outcome, and this is especially true for vulnerable patient groups including, patients over the age of 70, and those with diabetes, ischaemic heart disease, chronic respiratory disease and hypertension.
The World health organisation recommend that systemic corticosteroids should be avoided in patients with COVID-19 unless indicated for another reason. This is because there is evidence from a early study of patients in Wuhan that corticosteroids may cause delayed COVID-19 viral clearance. Furthermore, corticosteroids have been associated with an increased risk for mortality in patients with influenza and delayed viral clearance in patients with Middle East respiratory syndrome.
NHS england offer a comprehensive guide on the suitability of steroids in Rheumatic and MSK conditions. The document is supported by the Chartered Society of Physiotherapy (CSP), British Association of Orthopaedics (BOA), British Association of Spinal Surgeons (BASS) and the British Society for Rheumatology (BSR). The British society of skeletal radiologists, Faculty of pain medicine, British and the college of Podiatry have also published recommendations.