Steroid injections in musculoskeletal conditions and COVID infection rates: what is the impact on positive rates following the injection?

Background and Aim Therapeutic glucocorticosteroid injections are commonly utilised to manage musculoskeletal (MSK) complaints. Following the SARS-CoV-2 pandemic, national guidelines advised against their use due to potential immunosuppressant effects. The aim of the study was to determine whether steroid injections for MSK conditions impacts on positive COVID 19 infection rates. Patients and Methods This retrospective evaluation involved primary care participants who received a steroid injection for a MSK condition. 291 participants receiving a total of 299 steroid injections entered the study between the 25 September 2020 and the 29 April 2021. Results Six participants had positive polymerase chain reaction (PCR) tests, averaging 22.83 days (SD 10.48) after the injection. An infection rate of 2.06% was demonstrated in the injection group with the control group demonstrating 6.97% (p = 0.000752) with statistical significance set at p = 0.05. The odds ratio was identified as 0.27 indicating a lower odds of a positive PCR test compared with the control group. Conclusions This retrospective evaluation found a low risk of positive PCR tests for low and moderate COVID-19 risk patients injected during the COVID-19 pandemic. Glucocorticosteroid injections within the COVID-19 pandemic were not associated with higher COVID-19 rates compared to the local population, in fact, they were related to lower rates. For future studies, large scale studies and meta analyses are needed to provide greater generalisation to the population.