BACKGROUND: During the novel Coronavirus 2019 (COVID-19) worldwide pandemic, viral testing has largely focused on patients presenting with fever and respiratory symptoms. Although Centers for Disease Control has reported 1,551,095 cases in the United States as of May 21, 2020, asymptomatic infection rates remain unknown within the U.S., especially in geographically disparate regions. METHODS: On April 7, 2020 our hospital established universal SARS-CoV-2 screening using RT-PCR RNA detection from nasopharyngeal swabs from asymptomatic patients prior to essential and elective surgeries. This study included 1,997 asymptomatic patients undergoing surgical procedures and 1,797 admitted for medical management at a Midwestern academic hospital between April 7, 2020 and May 21, 2020. RESULTS: As of May 21, asymptomatic testing for SARS-CoV-2 infection had been completed for 1,997 surgical patients and 1,797 non-surgical patients. Initial testing was positive in 26 patients, with an additional four positive tests occurring during repeat testing when greater than 48 hours had elapsed since initial testing. Overall asymptomatic infection rate was 0.79%. Asymptomatic infection rate was significantly lower in surgical patients (0.35% vs. 1.28%, p=0.001). Surgical patients tended to be older than non-surgical patients, although this was not statistically significant (51, IQR 27-65 vsx 46, IQR 28-64, p=0.057). Orthopedic surgery patients were significantly younger than those from other surgical services (42 vs. 53 yrs, p<0.001), however orthopedic and non-orthopedic surgical patients had similar asymptomatic infection rates (0.70% vs. 0.25%, p=0.173). CONCLUSION: Among asymptomatic patients tested at a Midwestern academic medical center, 0.79% were infected with SARS-CoV-2 virus. These findings will help guide screening protocols at medical centers while providing essential and elective procedures during the COVID-19 pandemic. While the asymptomatic infection rate was low, this data substantiates the threat of asymptomatic infections and potential for community viral spread. These results may not be generalizable to large urban population centers or areas with high concentrations of COVID-19, each region must use available data to evaluate the risk-benefit ratio of universal testing vs universal contact precautions.Level of Evidence: IV.
BACKGROUND: During the novel Coronavirus 2019 (COVID-19) worldwide pandemic, viral testing has largely focused on patients presenting with fever and respiratory symptoms. Although Centers for Disease Control has reported 1,551,095 cases in the United States as of May 21, 2020, asymptomatic infection rates remain unknown within the U.S., especially in geographically disparate regions. METHODS: On April 7, 2020 our hospital established universal SARS-CoV-2 screening using RT-PCR RNA detection from nasopharyngeal swabs from asymptomatic patients prior to essential and elective surgeries. This study included 1,997 asymptomatic patients undergoing surgical procedures and 1,797 admitted for medical management at a Midwestern academic hospital between April 7, 2020 and May 21, 2020. RESULTS: As of May 21, asymptomatic testing for SARS-CoV-2 infection had been completed for 1,997 surgical patients and 1,797 non-surgical patients. Initial testing was positive in 26 patients, with an additional four positive tests occurring during repeat testing when greater than 48 hours had elapsed since initial testing. Overall asymptomatic infection rate was 0.79%. Asymptomatic infection rate was significantly lower in surgical patients (0.35% vs. 1.28%, p=0.001). Surgical patients tended to be older than non-surgical patients, although this was not statistically significant (51, IQR 27-65 vsx 46, IQR 28-64, p=0.057). Orthopedic surgery patients were significantly younger than those from other surgical services (42 vs. 53 yrs, p<0.001), however orthopedic and non-orthopedic surgical patients had similar asymptomatic infection rates (0.70% vs. 0.25%, p=0.173). CONCLUSION: Among asymptomatic patients tested at a Midwestern academic medical center, 0.79% were infected with SARS-CoV-2 virus. These findings will help guide screening protocols at medical centers while providing essential and elective procedures during the COVID-19 pandemic. While the asymptomatic infection rate was low, this data substantiates the threat of asymptomatic infections and potential for community viral spread. These results may not be generalizable to large urban population centers or areas with high concentrations of COVID-19, each region must use available data to evaluate the risk-benefit ratio of universal testing vs universal contact precautions.Level of Evidence: IV.
Authors: J Parvizi; T Gehrke; C A Krueger; E Chisari; M Citak; S Van Onsem; W L Walter Journal: J Bone Joint Surg Am Date: 2020-07-15 Impact factor: 6.558
Authors: Melissa M Arons; Kelly M Hatfield; Sujan C Reddy; Anne Kimball; Allison James; Jesica R Jacobs; Joanne Taylor; Kevin Spicer; Ana C Bardossy; Lisa P Oakley; Sukarma Tanwar; Jonathan W Dyal; Josh Harney; Zeshan Chisty; Jeneita M Bell; Mark Methner; Prabasaj Paul; Christina M Carlson; Heather P McLaughlin; Natalie Thornburg; Suxiang Tong; Azaibi Tamin; Ying Tao; Anna Uehara; Jennifer Harcourt; Shauna Clark; Claire Brostrom-Smith; Libby C Page; Meagan Kay; James Lewis; Patty Montgomery; Nimalie D Stone; Thomas A Clark; Margaret A Honein; Jeffrey S Duchin; John A Jernigan Journal: N Engl J Med Date: 2020-04-24 Impact factor: 91.245
Authors: Daniel F Gudbjartsson; Agnar Helgason; Hakon Jonsson; Olafur T Magnusson; Pall Melsted; Gudmundur L Norddahl; Jona Saemundsdottir; Asgeir Sigurdsson; Patrick Sulem; Arna B Agustsdottir; Berglind Eiriksdottir; Run Fridriksdottir; Elisabet E Gardarsdottir; Gudmundur Georgsson; Olafia S Gretarsdottir; Kjartan R Gudmundsson; Thora R Gunnarsdottir; Arnaldur Gylfason; Hilma Holm; Brynjar O Jensson; Aslaug Jonasdottir; Frosti Jonsson; Kamilla S Josefsdottir; Thordur Kristjansson; Droplaug N Magnusdottir; Louise le Roux; Gudrun Sigmundsdottir; Gardar Sveinbjornsson; Kristin E Sveinsdottir; Maney Sveinsdottir; Emil A Thorarensen; Bjarni Thorbjornsson; Arthur Löve; Gisli Masson; Ingileif Jonsdottir; Alma D Möller; Thorolfur Gudnason; Karl G Kristinsson; Unnur Thorsteinsdottir; Kari Stefansson Journal: N Engl J Med Date: 2020-04-14 Impact factor: 91.245
Authors: Ellen de Bock; Mando D Filipe; Roger K J Simmermacher; A Christiaan Kroese; Menno R Vriens; Milan C Richir Journal: BMJ Open Date: 2022-07-07 Impact factor: 3.006
Authors: Irfan A Khan; Musa B Zaid; Peter A Gold; Matthew S Austin; Javad Parvizi; Nicholas A Bedard; David S Jevsevar; Charles P Hannon; Yale A Fillingham Journal: J Arthroplasty Date: 2022-05-06 Impact factor: 4.435