The Impact of COVID-19 Infection on Concurrent Traumatic Insults: An Analysis from the West Virginia Trauma System

Santiago Lopez, BS, Cristhian Perez Torrico, BS, Connie DeLa'O, MD
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Abstract

Introduction With the onset of the COVID-19 pandemic, elective surgeries were decreased and associated with worsened outcomes. Trauma outcomes have been varied, and rural traumas have not been solely analyzed. This study investigated outcomes related to COVID-19 infection at a rural Level I trauma center in West Virginia (WV). Methods A retrospective analysis of trauma outcomes of patients aged 18 years and older from March 30, 2020, until December 21, 2021, presenting to a Level I trauma center in WV was conducted. Data was collected from the John Michael Moore Trauma Center trauma registry. Mortality, complications, injury characteristics, comorbidities, and demographics were examined. Results Out of 2,118 patients tested for the novel coronavirus, 61 (1.7%) were positive (COV+). There was no significant increase in mortality regarding COVID-19 infection. COV+ patients had an increased length of stay (median 5.2 vs. 3.6, p=0.015) and intubation rates (21.3% vs. 12.5%, p=0.070), but fewer days on a ventilator (median, 2 vs. 3, p=0.012). COV+ patients were more likely to be discharged to rehabilitation centers, skilled nursing facilities, or long-term acute care hospitals (44.3% vs 34.5%), and less often routine or home measures (42.6% vs. 58.7%) (p=0.015). Conclusion This single retrospective study found increased rates of length of stay and intubation rates with no increased rates of mortality or complications in COV+ trauma patients compared to non-COV+ trauma patients. Further research is needed to validate and characterize the impact of COVID-19 for the entirety of the state.
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COVID-19感染对并发创伤性损伤的影响:来自西弗吉尼亚州创伤系统的分析
随着COVID-19大流行的发生,选择性手术减少并与预后恶化相关。创伤的结果是多种多样的,农村创伤并没有被单独分析。本研究调查了西弗吉尼亚州农村一级创伤中心与COVID-19感染相关的结果。方法回顾性分析2020年3月30日至2021年12月21日在武汉市某创伤一级中心就诊的18岁及以上患者的创伤结局。数据收集自约翰·迈克尔·摩尔创伤中心创伤登记处。检查死亡率、并发症、损伤特征、合并症和人口统计学。结果在2118例新型冠状病毒检测中,61例(1.7%)呈阳性。COVID-19感染的死亡率没有显著增加。COV+患者的住院时间(中位数5.2 vs. 3.6, p=0.015)和插管率(21.3% vs. 12.5%, p=0.070)增加,但使用呼吸机的天数减少(中位数,2 vs. 3, p=0.012)。COV+患者更有可能出院到康复中心、专业护理机构或长期急症护理医院(44.3%对34.5%),而常规或家庭措施的频率更低(42.6%对58.7%)(p=0.015)。结论该单一回顾性研究发现,与非COV+创伤患者相比,COV+创伤患者的住院时间和插管率增加,但死亡率或并发症发生率未增加。需要进一步的研究来验证和描述COVID-19对整个国家的影响。
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