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COVID-19 Infection After Total Joint Arthroplasty Is Associated With Increased Complications.
Forlenza, Enrico M; Higgins, John D D; Burnett, Robert A; Serino, Joseph; Della Valle, Craig J.
  • Forlenza EM; Rush University Medical Center, Chicago, IL.
  • Higgins JDD; Rush University Medical Center, Chicago, IL.
  • Burnett RA; Rush University Medical Center, Chicago, IL.
  • Serino J; Rush University Medical Center, Chicago, IL.
  • Della Valle CJ; Rush University Medical Center, Chicago, IL.
J Arthroplasty ; 37(7S): S457-S464, 2022 07.
Article in English | MEDLINE | ID: covidwho-1693927
ABSTRACT

BACKGROUND:

The impact of a postoperative diagnosis of COVID-19 in patients undergoing total joint arthroplasty (TJA) remains unknown. The objective of this study is to characterize the effect of COVID-19 infection following TJA on perioperative complication rates.

METHODS:

The Mariner database was queried for patients undergoing total hip and total knee arthroplasty from January 2018 to April 2020. TJA patients who were diagnosed with COVID-19 within 90 days postoperatively were matched in a 13 fashion based on age, gender, iron deficiency anemia, payer status, and Charlson Comorbidity Index with patients who were not diagnosed with COVID-19. Preoperative comorbidity profiles and complications within 3 months of surgery were compared. Statistical analysis included chi-squared tests and multivariate logistic regression with outcomes considered significant at P < .05.

RESULTS:

Of the 239 COVID-19 positive patients, 132 (55.2%) underwent total hip arthroplasty. On multivariate analysis, COVID-19 diagnosis was associated with increased odds of deep vein thrombosis (odds ratio [OR] 4.86, 95% confidence interval [CI] 2.10-11.81, P < .001), pulmonary embolism (OR 6.27, 95% CI 2.57-16.71, P < .001), and all complications (OR 3.36, 95% CI 2.47-4.59, P < .001). Incidence of deep vein thrombosis/pulmonary embolism was greater the closer in time the COVID-19 diagnosis was to the surgical procedure (10.24 times at 1 month, 7.87 times at 2 months, and 1.42 times at 3 months; P < .001). A similar relationship was observed with all complications.

CONCLUSION:

Postoperative COVID-19 infection is associated with higher rates of cardiopulmonary complications, thromboembolic disease, renal injury, and urinary tract infections in patients undergoing hip and knee arthroplasty. COVID-19 infection earlier in the postoperative period is associated with a higher risk of complications.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pulmonary Embolism / Arthroplasty, Replacement, Hip / Arthroplasty, Replacement, Knee / Venous Thrombosis / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: J Arthroplasty Journal subject: Orthopedics Year: 2022 Document Type: Article Affiliation country: J.arth.2021.10.023

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pulmonary Embolism / Arthroplasty, Replacement, Hip / Arthroplasty, Replacement, Knee / Venous Thrombosis / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: J Arthroplasty Journal subject: Orthopedics Year: 2022 Document Type: Article Affiliation country: J.arth.2021.10.023