Clinica di Ortopedia e Traumatologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
J Orthop Trauma. 2020 Oct;34(10):e389-e397. doi: 10.1097/BOT.0000000000001905.
Fifty-eight percent of the total infections in Italy of COVID-19 were found in northern Italy, in particular, Lombardy. From February 21, 2020, to March 23, 2020, 20 patients with a fracture and a diagnosis of COVID-19 were hospitalized. Demographic data, COVID-19 symptoms, laboratory and radiographic examinations, and treatment methods were recorded. At 1-month follow-up, patients were assessed with the SF-36 score. This case series includes 20 patients (16 women and 4 men), with an average age of 82.35 years (range 59-95). Eleven patients (55%) had a femur fracture. Fourteen patients (70%) had 3 or more comorbidities or previous pathologies. Three patients with severe comorbidities died during the hospitalization. Thirteen patients (65%) had fever, 18 patients (90%) asthenia, and 17 patients (85%) dyspnea. All patients (100%) were given antibiotic therapy, whereas 16 patients (80%) underwent hydroxychloroquine therapy and 8 (40%) were treated with corticosteroids. Eighteen patients (90%) underwent antithromboembolic prophylaxis. Eighteen patients (90%) had lymphopenia. All 20 patients (100%) required noninvasive mechanical ventilation. High D-dimer and polymerase chain reaction values were found in all patients (100%), whereas lactate dehydrogenase was increased in 18 patients (90%). Patients with fractures, especially in the lower limbs, frequently require hospitalization, making these patients more subjected to the risk of COVID-19 infection. COVID-19 infection therefore does not seem to influence the fracture pattern in the elderly population but can lead to health deterioration with increased mortality. The typical symptoms of COVID-19 disease have not changed when associated with a fracture or trauma. Laboratory data are in line with what is reported in recent studies, whereas a more invasive assisted ventilation is associated with a poor prognosis. Finally, analyzing the data obtained from the SF-36 score, significantly lower values emerged when compared with those reported in the literature. LEVEL OF EVIDENCE:: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
意大利 COVID-19 总感染人数的 58%发生在意大利北部，特别是伦巴第大区。从 2020 年 2 月 21 日至 2020 年 3 月 23 日，共有 20 名骨折并确诊 COVID-19 的患者住院。记录了人口统计学数据、COVID-19 症状、实验室和影像学检查以及治疗方法。在 1 个月的随访中，使用 SF-36 评分对患者进行评估。本病例系列包括 20 名患者（16 名女性和 4 名男性），平均年龄为 82.35 岁（59-95 岁）。11 名患者（55%）股骨骨折。14 名患者（70%）有 3 种或更多合并症或既往病史。3 名患有严重合并症的患者在住院期间死亡。13 名患者（65%）发热，18 名患者（90%）乏力，17 名患者（85%）呼吸困难。所有患者（100%）均接受抗生素治疗，16 名患者（80%）接受羟氯喹治疗，8 名患者（40%）接受皮质类固醇治疗。18 名患者（90%）接受抗血栓栓塞预防。18 名患者（90%）淋巴细胞减少。所有 20 名患者（100%）均需要无创机械通气。所有患者（100%）的高 D-二聚体和聚合酶链反应值升高，18 名患者（90%）乳酸脱氢酶升高。骨折患者，尤其是下肢骨折患者，经常需要住院治疗，因此这些患者更容易感染 COVID-19。COVID-19 感染似乎不会影响老年人群的骨折类型，但会导致健康状况恶化，死亡率增加。COVID-19 疾病的典型症状与骨折或创伤无关。实验室数据与最近的研究报告一致，而更具侵袭性的辅助通气与预后不良相关。最后，通过分析从 SF-36 评分中获得的数据，与文献报告的数据相比，明显较低。证据水平：预后 IV 级。请参阅作者说明，以获取完整的证据水平描述。
