Steroid Injections and Covid 19, (Nov 2020)

Steroid injections are a common podiatric procedure used to reduce pain.  Their duration of effect is variable but can provide indefinite benefit. The immunological impact of steroids given this way to patients with COVID-19 is unknown. As a result of the long quarantine period of an average of 14 days, there is  a risk that asymptomatic patients who are carrying the virus could be treated /injected thus potentially putting them at increased risk of an adverse outcome from the virus.  


Use of steroids: possible impact in relation to COVID-19. The current WHO guidance for the management of severe acute respiratory infection in patients with COVID-19 is to avoid the routine use of systemic corticosteroids unless indicated for another reason. This is because steroids have been associated with an increased risk for mortality in patients with influenza and delayed viral clearance in patients with Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Although they were widely used in the management of severe acute respiratory syndrome (SARS), there was no good evidence for benefit, and there was persuasive evidence of adverse short-and long-term harm 2. A recent study of patients with COVID in China reports that patients receiving corticosteroids did not have an effect on mortality, but rather delayed viral clearance 3.  Injections must not be undertaken in individuals with active infections. However,     individuals who may be incubating or later develop COVID-19, may incur harmful effects if injected with steroids.