BACKGROUND: The SARS-Cov-2 coronavirus has varying clinical effects-from asymptomatic patients to life-threatening illness and death. At the only Level 1 Trauma Center in a rural state, outcomes appeared worse in trauma patients who tested positive for COVID despite these patients presumably being asymptomatic or only mildly affected before their traumatic event. This study compares all trauma admissions that were COVID-positive to those who were not. METHODS: The institutional database was queried for all level 1 and 2 trauma activations from March 2020-July 2021. The analysis consisted of a multivariate regression between COVID-negative and the COVID-positive group controlling for age, injury severity score (ISS), and Glasgow Coma Score (GCS). Outcomes compared were hospital length-of-stay (LOS), ICU LOS, ventilator days, days to discharge to a facility, and in-hospital mortality. RESULTS: Hospital LOS was 2.7 days longer in the COVID-positive group (P < .0005). ICU LOS was 2.9 days longer for patients admitted to the ICU in the COVID positive-group (P = .017). Ventilator days were 4.7 days longer for patients requiring mechanical ventilation in the COVID-positive group (P = .002). Discharge to a post-acute facility required 6.1 more days in the COVID-positive group (P = .005). CONCLUSION: Trauma patients presenting positive for COVID-19 are presumed to be asymptomatic before their traumatic event. Despite this, the physiologic toll of trauma combined with the COVID infection causes significantly worse clinical outcomes, including increasing hospital days in this patient population, which continues to tax the already burdened healthcare system.
BACKGROUND: The SARS-Cov-2 coronavirus has varying clinical effects-from asymptomatic patients to life-threatening illness and death. At the only Level 1 Trauma Center in a rural state, outcomes appeared worse in trauma patients who tested positive for COVID despite these patients presumably being asymptomatic or only mildly affected before their traumatic event. This study compares all trauma admissions that were COVID-positive to those who were not. METHODS: The institutional database was queried for all level 1 and 2 trauma activations from March 2020-July 2021. The analysis consisted of a multivariate regression between COVID-negative and the COVID-positive group controlling for age, injury severity score (ISS), and Glasgow Coma Score (GCS). Outcomes compared were hospital length-of-stay (LOS), ICU LOS, ventilator days, days to discharge to a facility, and in-hospital mortality. RESULTS: Hospital LOS was 2.7 days longer in the COVID-positive group (P < .0005). ICU LOS was 2.9 days longer for patients admitted to the ICU in the COVID positive-group (P = .017). Ventilator days were 4.7 days longer for patients requiring mechanical ventilation in the COVID-positive group (P = .002). Discharge to a post-acute facility required 6.1 more days in the COVID-positive group (P = .005). CONCLUSION: Trauma patients presenting positive for COVID-19 are presumed to be asymptomatic before their traumatic event. Despite this, the physiologic toll of trauma combined with the COVID infection causes significantly worse clinical outcomes, including increasing hospital days in this patient population, which continues to tax the already burdened healthcare system.
Authors: Anne Knisely; Zhen Ni Zhou; Jenny Wu; Yongmei Huang; Kevin Holcomb; Alexander Melamed; Arnold P Advincula; Anil Lalwani; Fady Khoury-Collado; Ana I Tergas; Caryn M St Clair; June Y Hou; Dawn L Hershman; Mary E D'Alton; Yolanda Ya-Chin Huang; Jason D Wright Journal: Ann Surg Date: 2021-01-01 Impact factor: 12.969
Authors: Max R Haffner; Hai V Le; Augustine M Saiz; Gloria Han; Jeffrey Fine; Philip Wolinsky; Eric O Klineberg Journal: JAMA Netw Open Date: 2021-04-01
Authors: Margherita Macera; Giulia De Angelis; Caterina Sagnelli; Nicola Coppola Journal: Int J Environ Res Public Health Date: 2020-07-14 Impact factor: 3.390
Authors: Kenneth A Egol; Sanjit R Konda; Mackenzie L Bird; Nicket Dedhia; Emma K Landes; Rachel A Ranson; Sara J Solasz; Vinay K Aggarwal; Joseph A Bosco; David L Furgiuele; Abhishek Ganta; Jason Gould; Thomas R Lyon; Toni M McLaurin; Nirmal C Tejwani; Joseph D Zuckerman; Philipp Leucht Journal: J Orthop Trauma Date: 2020-08 Impact factor: 2.512
Authors: Drake G LeBrun; Maxwell A Konnaris; Gregory C Ghahramani; Ajay Premkumar; Chris J DeFrancesco; Jordan A Gruskay; Aleksey Dvorzhinskiy; Milan S Sandhu; Elan M Goldwyn; Christopher L Mendias; William M Ricci Journal: J Orthop Trauma Date: 2020-08 Impact factor: 2.512
Authors: Brajesh K Lal; Nikhil K Prasad; Brian R Englum; Douglas J Turner; Tariq Siddiqui; Minerva Mayorga Carlin; Rachel Lake; John D Sorkin Journal: Am J Surg Date: 2020-12-28 Impact factor: 3.125