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Transfusion Medicine and Hemotherapy ; 49(Supplement 1):73, 2022.
Article in English | EMBASE | ID: covidwho-2223885


Background: Bone allografts have been an integral part of orthopedic procedures such as revision hip surgery or reconstruction of large bone defects. Femoral heads and necks were harvested from living donors undergoing total hip arthroplasty (THA). They were stored fresh frozen or processed into bone chips by the Innsbruck Bone Bank. The challenge was to meet the demand for bone grafts through in-house manufacturing even during Covid-19 pandemic restrictions. Method(s): Key data from the bone bank's registry and the hospital administration between January 2019 and March 2022 were analysed with regard to collection of fresh frozen allogenic femoral heads /necks and the manufacture of bone chips and their discard. Donor suitability and release criteria were assessed in accordance with EU and national legislation. Result(s): In 1,249 primary THA surgeries 640 femoral heads and necks were harvested. In the mean 51.4% of these yielded the bulk material for bone chips manufacture. Due to Covid-19 pandemic restrictions the number of grafts retrieved was lowest in Q1 2020 and Q4 2021. The proportion of unreleased transplants remained fairly consistent at 14%, but the reasons for discard varied: technical issues were eliminated, but the increase for discard to >30% due to reasons in donor history required the revision of the questionnaire and the collaboration with the team responsible for listing diagnoses in the medical records. By 2020, the bone chip discard rate had increased to 8%. Hence modification of cleaning and gowning brought it back down to 2% . Conclusion(s): Providing high quality bone allografts is a complex task. In this context, it is important to regularly evaluate the registry data and to modify the process accordingly, thus ensuring adequate supply of allografts even in times of significant restrictions.

Open Forum Infectious Diseases ; 8(SUPPL 1):S308-S309, 2021.
Article in English | EMBASE | ID: covidwho-1746578


Background. At the onset of the COVID-19 pandemic, hospitals implemented infection control measures with limited data on predictors of nosocomial SARS-CoV-2 transmission. We aimed to quantify SARS-CoV-2 presence in an inpatient setting to understand nosocomial risk. Methods. Patients admitted with confirmed SARS-CoV-2 infection at an urban academic hospital were enrolled. Demographic/clinical characteristics, a PCR nasal swab(NS), and air samples on filter media in the near- (< 6ft) and far-field ( >6ft) of each patient for 3.5 hours were collected. PCR was used to detect SARS-CoV-2 on filter media. Associations between clinical characteristics and presence of SARS-CoV-2 in air samples used Fisher's exact and Wilcoxon rank sum tests. Results. Of 52 subjects, 46% had no detectable virus by nasal swab on the day of sampling. Of 104 room air samples, 16% had detectable virus from 25% of rooms, including 10 near and 7 far field samples. Subjects with a positive room air sample had fewer days from symptom-onset compared with those with a negative air sample (median 6 vs. 8, p=0.24). Being on room air and having a nasal swab positive increased the odds of detecting virus in air samples but were not statistically significant. Conclusion. A small number of air samples with detectable SARS-CoV-2 may suggest lower nosocomial risk than previously anticipated. Multiple subject and environmental factors may have contributed to this finding including patient source control masking, anti-viral therapies and HEPA filtration. The decreased association of virus in the air of those with more days of symptoms but with the need for supplemental oxygen may be related to what is now known about the COVID-19 inflammatory response after the infectious period.