Nosocomial infection with SARS-CoV-2 and main outcomes after surgery within an orthopaedic surgery department in a terti
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ORIGINAL PAPER
Nosocomial infection with SARS-CoV-2 and main outcomes after surgery within an orthopaedic surgery department in a tertiary trauma centre in Spain Kushal Lakhani 1,2 Jorge H. Núñez 1,2
&
Joan Minguell 1,2 & Ernesto Guerra-Farfán 1,2 & Yuri Lara 1,2 & Unai Jambrina 1,2 & Joan Pijoan 1,2 &
Received: 2 July 2020 / Accepted: 1 September 2020 # SICOT aisbl 2020
Abstract Aims The purpose of the present study is to analyse clinical data of a series of cases who developed nosocomial infection with SARS-CoV-2 in an orthopaedic and traumatology department. Patients and methods In this non-interventional retrospective study, carried out at a tertiary hospital within the Spanish National Health System, all adult patients who were admitted in the Orthopaedic Surgery and Traumatology Department between March 9th and May 4th, 2020, were included. Clinical, biological and radiological data, as well as mortality rates, were collected from hospital medical records. Results A total of 293 periods of hospitalization were analysed in 288 patients. Mean age was 66.1 years old and 57.3% were females. Nineteen patients (6.48%) met the inclusion criteria to be categorized as a nosocomial infection with SARS-CoV-2. In a comparison between patients with and without nosocomial infection, age, mortality and hospital length of stay were statistically significant (p < 0.05). The median time from admission to diagnosis of SARS-CoV-2 infection in our cohort was 16 days (6– 86 days). No statistically significant differences were found in sex, living situation, reason of admission or period of admission (even if we observed that most of the nosocomial infections (78.9%) occurred in March). Conclusion We have found a 6.48% of nosocomial infection with SARS-CoV-2, but with an important reduction of it after undergoing preventing protocols that included screening RT-PCR test for COVID-19. Age and hospital length stay were statistically significant risk factors for nosocomial infection with SARS-CoV-2. For the progressive restoration of the surgical activity, we recommend to correctly select the patients in elective surgery and to encourage fast-track programs and early discharge of patients with fractures. Keywords Nosocomial infection . SARS-CoV-2 . Coronavirus . COVID-19 . Surgery . Orthopaedic
Introduction On January 20th, 2020, the World Health Organization (WHO) declared a public health emergency due to a new coronavirus disease: severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This coronavirus disease 2019 * Kushal Lakhani [email protected]; [email protected] 1
Department of Traumatology and Orthopedic Surgery, University Hospital of Vall d’Hebron, Passeig de la Vall d’Hebron, 119-129 08035 Barcelona Spain
2
Universitat Autónoma de Barcelona, Passeig de la Vall d’Hebron, 119-129 08035 Barcelona Spain
(COVID-19) was classified as a pandemic on March 11th, 2020. Spain was one of the first European countries to deal with this virus outbreak, declaring the State of Alarm on March 14th, 2020. This State
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