[Translated article] Has 2020 been a lost year in orthopaedic surgery and trauma training? Residents' perceptions.

OBJECTIVE: The COVID-19 pandemic has affected specialised healthcare training at all levels. Surgical learning has been severely affected, and the impact on orthopaedic surgery residency training has so far not been assessed. MATERIAL AND METHODS: An online survey of 17 questions was sent via web link to orthopaedic surgery residents throughout Spain between February 10, 2021 and February 28, 2021. The effects of the COVID-19 pandemic on the care and training activities of residents were analysed. RESULTS: A total of 307 orthopaedic surgery residents from all over Spain responded to the online survey. A total of 77.2% of the respondents had to suspend their rotations. Of these, 67.5% would like to resume the rotations they missed during the pandemic. A total of 69.7% of scheduled surgeries were suspended. Surgical activity was completely stopped for an average of 8 weeks. 66.8% of the residents consider that their surgical training has been affected and this will have repercussions on their future work. 49.5% considered the online training offered to be insufficient. Of the total number of respondents, 52.1% considered that the impact of the pandemic situation on their training situation was bad or very bad. CONCLUSIONS: The data collection shows a negative impact on both theoretical and clinical training. This study highlights the need to continue offering quality training by maximising learning opportunities.

Incidence and evolution of SARS-CoV2 infection in patients with inflammatory bowel disease in Southern Spain (Andalusia)

Introduction: The respiratory infection caused by SARS-CoV2, known as COVID-19, has presented a fast worldwide expansion with significant sanitary repercussion as well as social and economic. Globally, patients with inflammatory bowel disease (IBD) have been considered as population at risk for viral infections. To date, the evidence has not proved an increased risk for COVID-19 in this group. Aims & Methods: Our aim was to describe the main characteristics of our IBD patients who suffered SARS-CoV2 infection and to analyze both the evolution of their IBD and the infection's evolution. An observational, longitudinal, ambispective and multicentric study was performed. Patients with IBD with positive SARS-CoV2 PCR were included. Demographic variables along with data regarding to the COVID-19 infection were collected. SPSS® software version 20.0 was used for the statistic analysis. Results: We included 97 patients, 51.5% men. Overall mean age 43 (16-73) years old. Active smokers 13.5%, hypertensive 15.5%, diabetics 7.2% and obese 6.2%. According to the IBD 39.2% suffered from ulcerative colitis (UC), 55.7% Crohn's disease (CD), 2.1% linfocitic colitis and 2.1% indeterminate colitis. Mean IBD duration was 10.3 (SD 8.3) years. Perianal disease was present in 16.5% and extraintestinal manifestations (EIMs) 26.8% (77% joint involvement). Upon the time of infection 28.4% had active IBD. Regarding treatment, 55.7% were on aminosalycilates (5ASA), 45.8% on immunosuppressants, 25% on steroids and 41.7% on biologics. The main symptoms of SARS-CoV2 infection were astenia (62%), cough (60%), fever (58%), headache (52%) and diarrhoea (45%). Hospital admission was required in 24.2% (61% suffering from severe respiratory disease) and ICU was required in 17.4% of them. There were no deaths. Compared to those who did not need hospital admission;the admitted patients were older (50 vs 40 years old, p=0.006), were more likely to be obese (20% vs 2.8%, p=0.017), to suffer from hypertension (39% vs 8.3%, p=0.0001), from heart failure (13% vs 0%, p=0.002), had more EIMs (43.5% vs 22.2%, p= 0.047), had a higher previous hospitalization within the last 3 months (43.3% vs 8.3%, p=0.002), were more on 5ASA (91.3% vs 45.8%, p=0.0001) and showed higher C-reactive protein levels (71 vs 13.7, p=0.017). Hospitalized patients were more likely to present diarrhoea (63.8% vs 36.2%, p=0.009), dyspnoea (65.2% vs 20.6%, p=0.0001), hypoxemia (39.1% vs 1.5%, p=0.0001), hyporexia (60.9% vs 19.1%, p=0.0001), abdominal pain (36.4% vs 14.5%, p=0.025) and fever (82.6% vs 50%, p=0.006). Related to need of ICU admission, EIMs (75% vs 25.3%, p=0.029) and previous admission within the last 3 months (50% vs 13.2%, p=0.042), were more frequent. Neither immunosuppressant treatment (45.8% vs 47.8%, p=0.87) nor biologic therapy (43.1% vs 34.8%, p=0.48) were related to the need for hospital admission. Conclusion: A quarter part of the patients with IBD and SARS-CoV2 infection needed hospitalisation. An older age, presence of comorbidities, hospital admission within the previous 3 months, treatment with 5ASA and EIMs were more frequent in those requiring admission. There was not identified any relation between active IBD or the use of immunosuppressants/ biologics and a worse evolution of the infection.

[Has 2020 been a lost year in orthopedic surgery and trauma training? Residents' perceptions]. / ¿Ha sido el 2020 un año perdido en la formación de cirugía ortopédica y traumatología? Percepción de los residentes.

Objective: The COVID-19 pandemic has affected specialized healthcare training at all levels. Surgical learning has been severely affected, and the impact on orthopedic surgery residency training has so far not been assessed. Material and methods: An online survey of 17 questions was sent via web link to orthopedic surgery residents throughout Spain between February 10, 2021 and February 28, 2021. The effects of the COVID-19 pandemic on the care and training activities of residents were analyzed. Results: A total of 307 orthopedic surgery residents from all over Spain responded to the online survey. A total of 77.2% of the respondents had to suspend their rotations. Of these, 67.5% would like to resume the rotations they missed during the pandemic. A total of 69.7% of scheduled surgeries were suspended. Surgical activity was completely stopped for an average of 8 weeks. 66.8% of the residents consider that their surgical training has been affected and this will have repercussions on their future work. 49.5% considered the online training offered to be insufficient. Of the total number of respondents, 52.1% considered that the impact of the pandemic situation on their training situation was bad or very bad. Conclusions: The data collection shows a negative impact on both theoretical and clinical training. This study highlights the need to continue offering quality training by maximizing learning opportunities.