Steroid injections during the Coronavirus Pandemic

You have been referred to consider treatment for a condition that may be helped by a steroid injection. These have been used for conditions like yours for many years with good success although there have always been small risks associated with receiving the injection. These risks still exist, but with the Coronavirus, there are some extra risks that you should be aware of before choosing to have an injection. You can then decide whether injection of a steroid is the right treatment for you.

What are the normal risks when you have a steroid injection?

Receiving an injection has always carried with it very small risks, including:

  • the injection causing an infection
  • the injection damaging nearby nerves and tendons, which could rarely cause significantproblems
  • the steroid weakening and thinning nearby tissues
  • thinning of the skin and the fat under the skin causing lasting skin changes
  • the steroid injected into you is absorbed at low levels by your bloodstream and so if you arediabetic it may make your blood sugar control more difficult for a few weeks
  • facial flushing for a few days
What are the additional risks if you have a steroid injection during the
Coronavirus pandemic?

Due to the injected steroid being taken up by your body into the bloodstream, your body's immune system may be temporarily affected. It is not known for certain whether this has any practical effect on you catching Coronavirus or to the severity of any infection if you did catch it, but it is possible that it could. You should therefore pay particular attention to all of the normal measures advised to avoid catching Coronavirus in the few days before the injection and after it, such as strict social distancing and careful hand hygiene (washing or alcohol hand rub). Injection of steroid should be postponed if you are experiencing Coronavirus symptoms (or any other viral illness such as flu) at the time of your planned appointment (please contact your healthcare team if this occurs).

In terms of your susceptibility (risk of catching Coronavirus or other viruses), a study looking at people who had steroids injected into joints showed a 0.1% higher risk of catching flu in the following seasonal winter flu virus period. We still do not know if there is any increased risk of catching Coronavirus after having a steroid injection.

In terms of the severity of any Coronavirus infection, if you were to catch Coronavirus soon after receiving a steroid injection, the steroid might, in theory, reduce your body's ability to fight against an infection, but this has not been seen in patients so far.If you have other risk factors that make you particularly vulnerable for Coronavirus infection, it will be important to discuss carefully the risks and benefits of the injection with the people treating you; all patients should think through the information in this leaflet and discuss the options with their treating doctor to agree the best option for you.

What steps are healthcare professionals taking to keep you safe?

Health professionals will be following the appropriate national guidance of the time about use of steroids during the pandemic. In addition, the hospital or clinic setting where the injection is given will be set-up with social distancing and other protective measures in place with the aim to minimise the risk of exposure to coronavirus.