Holmes Natalie, Virani Siddharth, Relwani Jai
East Kent Hospital University Foundation NHS Trust, William Harvey Hospital, Ashford, Kent, United Kingdom.
J Clin Orthop Trauma. 2021 May;16:43-48. doi: 10.1016/j.jcot.2020.12.019. Epub 2021 Jan 13.
Orthopaedic practice changed during COVID-19 with elective work ceasing, trauma reducing and work forces redistributed to medical areas. During the United Kingdom lockdown, hospitals were stretched thinly with admissions of SARS-CoV-2 positive patients.
Evaluate orthopaedic admissions to a district general hospital during lockdown and the volume of those who subsequently were found to be COVID-19 positive.
Retrospective study of patients admitted under trauma and orthopaedics between March 23, 2020-June 18, 2020. Data includes; diagnosis, COVID-19 swab dates, results and mortality using orthopaedic admission sheets, patient and pathology electronic recording system.
3/4 of admitted patients tested negative for SARS-CoV-2 initially. Of these 240 patients, 12.5% subsequently tested positive during their stay, often within one week of their admission. 17.8% of patients were never tested. 7.8% mortality rate of which 48% were neck of femur fracture (NOF#) patients. 28 NOF# were confirmed COVID-19 positive; mortality rate of 21.4%. 87 NOF# were COVID-19 negative; mortality rate 6.9%. Mortality relative risk (RR) for NOF# and COVID-19 positive was 2.6. COVID-19 positive mortality 27% as compared to 4% in COVID-19 negative patients. Patients who acquired COVID-19 whilst in hospital had a mortality relative risk 6.4.
12.5% orthopaedic in-hospital viral transmission rate amongst orthopaedic patients despite the segregation measures taken, possibly due to asymptomatic health care workers or inpatients awaiting swab results. We emphasize the importance of testing all inpatients and regular testing of healthcare workers.
在2019冠状病毒病（COVID-19）疫情期间，骨科医疗实践发生了变化，择期手术停止，创伤病例减少，工作人员被重新分配到医疗领域。在英国封锁期间，医院因收治新型冠状病毒肺炎（SARS-CoV-2）阳性患者而不堪重负。
评估封锁期间一家地区综合医院的骨科住院情况以及随后被发现为COVID-19阳性的患者数量。
对2020年3月23日至2020年6月18日期间因创伤和骨科疾病入院的患者进行回顾性研究。数据包括：诊断、COVID-19拭子检测日期、结果以及使用骨科入院记录单、患者和病理电子记录系统的死亡率。
四分之三的入院患者最初SARS-CoV-2检测呈阴性。在这240名患者中，12.5%在住院期间随后检测呈阳性，通常在入院后一周内。17.8%的患者从未接受检测。死亡率为7.8%，其中48%为股骨颈骨折（NOF#）患者。28例NOF#确诊为COVID-19阳性；死亡率为21.4%。87例NOF#为COVID-19阴性；死亡率为6.9%。NOF#与COVID-19阳性的死亡相对风险（RR）为2.6。COVID-19阳性患者的死亡率为27%，而COVID-19阴性患者为4%。在医院感染COVID-19的患者的死亡相对风险为6.4。
尽管采取了隔离措施，但骨科患者中仍有12.5%的院内病毒传播率，这可能是由于无症状的医护人员或等待拭子检测结果的住院患者所致。我们强调对所有住院患者进行检测以及对医护人员进行定期检测的重要性。
