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J Arthroplasty ; 37(10): 2106-2113.e1, 2022 10.
Article in English | MEDLINE | ID: covidwho-1821138


BACKGROUND: The Coronavirus Disease 2019 (COVID-19) pandemic has caused a substantial number of patients to have their elective arthroplasty surgeries rescheduled. While it is established that patients with COVID-19 who are undergoing surgery have a significantly higher risk of experiencing postoperative complications and mortality, it is not well-known at what time after testing positive the risk of postoperative complications or mortality returns to normal. METHODS: PubMed (MEDLINE), Excerpta Medica dataBASE, and professional society websites were systematically reviewed on March 7, 2022 to identify studies and guidelines on the optimal timeframe to reschedule patients for elective surgery after preoperatively testing positive for COVID-19. Outcomes included postoperative complications such as mortality, pneumonia, acute respiratory distress syndrome, septic shock, and pulmonary embolism. RESULTS: A total of 14 studies and professional society guidelines met the inclusion criteria for this systematic review. Patients with asymptomatic COVID-19 should be rescheduled 4-8 weeks after testing positive (as long as they do not develop symptoms in the interim), patients with mild/moderate COVID-19 should be rescheduled 6-8 weeks after testing positive (with complete resolution of symptoms), and patients with severe/critical COVID-19 should be rescheduled at a minimum of 12 weeks after hospital discharge (with complete resolution of symptoms). CONCLUSIONS: Given the negative association between preoperative COVID-19 and postoperative complications, patients should have elective arthroplasty surgery rescheduled at differing timeframes based on their symptoms. In addition, a multidisciplinary and patient-centered approach to rescheduling patients is recommended. Further study is needed to examine the impact of novel COVID-19 variants and vaccination on timeframes for rescheduling surgery.

COVID-19 , Arthroplasty , COVID-19/epidemiology , Elective Surgical Procedures/adverse effects , Humans , Postoperative Complications/epidemiology , Postoperative Complications/etiology , SARS-CoV-2
J Arthroplasty ; 35(7S): S19-S22, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-205262


The coronavirus disease (COVID-19) pandemic caused by the severe acute respiratory syndrome (SARS-CoV-2) virus is challenging healthcare providers across the world. Current best practices for personal protective equipment (PPE) during this time are rapidly evolving and fluid due to the novel and acute nature of the pandemic and the dearth of high-level evidence. Routine infection control practices augmented by airborne precautions are paramount when treating the COVID-19-positive patient. Best practices for PPE use in patients who have unknown COVID-19 status are a highly charged and emotional issue. The variables to be considered include protection of patients and healthcare providers, accuracy and availability of testing, and responsible use of PPE resources. This article also explores the concerns of surgeons regarding possible transmission to their own family members as a result of caring for COVID-19 patients.

Betacoronavirus , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Personal Protective Equipment , Pneumonia, Viral/prevention & control , COVID-19 , Coronavirus Infections/epidemiology , Health Personnel , Humans , Infection Control , Orthopedics , Patient Care Team , Pneumonia, Viral/epidemiology , SARS-CoV-2