Infectious Disease

No difference in the length of stay for patients with and without a history of COVID-19 infection

August 07, 2021

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Jungwirth-Weinberger A, et al. Paper 796. Presented at: Annual Meeting of the Musculoskeletal Infection Society; 6-7 August 2021; Fort Lauderdale, Florida (hybrid meeting).

Disclosure:
Miller reports that he is a paid consultant for BoneSupport.

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In a large single-center study, patients with a history of COVID-19 infection who had an elective TJR during the pandemic did not differ from patients without a history of COVID-19 in terms of the average length of hospital stay or the rate of complications in the hospital.

Andy O. Miller, MD, presented the results at the annual meeting of the Musculoskeletal Infection Society.

He and his colleagues at the Hospital for Specialty Surgery examined the effects of a previous infection with SARS-CoV-2 on primary elective total joint replacement. The researchers focused on preoperative IgG antibody test results in 5,354 patients who underwent surgery between May 2020 and January 2021.

Andy O. Miller

Andy O. Miller

In total, the study compared 340 patients with a history of COVID-19 with 5,014 patients without a history of COVID-19. Within the group of patients who had either a positive RT-PCR test or a positive IgG antibody test for SARS-CoV-2, 42% had a history of COVID-19 symptoms and the time between symptoms and surgery averaged 168 Days, said Müller.

“Although there were no differences in age, gender, or comorbidity indices, patients with a history of COVID-19 were more likely to be black, Hispanic, obese, and anemic, and slightly less likely to have a history of rheumatoid arthritis,” he said.

About 43% of patients with a history of COVID-19 were obese versus about 32% with no history. In addition, a higher proportion of patients in the study with a history of COVID-19 were black (15%) versus approximately 6% of patients with no medical history, and a higher proportion of patients with a history of COVID-19 were Hispanic American (8, 10). 5%). ) vs. approx. 5.4% of patients without a medical history, according to the abstract.

The researchers found no difference in the use of regional anesthesia or outpatient surgery between the two cohorts.

Miller said this was the largest known cohort of patients who had surgery for elective TJR during the pandemic.

“The overall hospital complication rate was 0.4% with no significant intergroup difference and zero complications in our COVID-19 history cohort,” he said.

Speaking of the limitations of the study, Miller said it was possible for patients with a COVID-19 history to be self-selected and healthier than most COVID-19 survivors.

“We haven’t investigated any complications after hospital discharge. We may have been too weak to see increased risks for relatively rare outcomes. COVID-19 is not a randomly assigned disease and we are seeing associations, but certainly not causation, ”Miller said.

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Annual meeting of the Society for Musculoskeletal Infections

Annual meeting of the Society for Musculoskeletal Infections

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