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Universal Screening for COVID-19 in Children Undergoing Orthopaedic Surgery: A Multicenter Report.
Blumberg, Todd J; Adler, Adam C; Lin, Elaina E; Fazal, Faris Z; Talwar, Divya; Ellingsen, Kyle; Chandrakantan, Arvind; Chen, Jingyang; Shah, Apurva S.
  • Blumberg TJ; Department of Orthopedics and Sports Medicine, Seattle Children's Hospital.
  • Adler AC; Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Houston, TX.
  • Lin EE; Department of Anesthesiology and Critical Care Medicine.
  • Fazal FZ; Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA.
  • Talwar D; Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA.
  • Ellingsen K; University of Washington School of Medicine, Seattle, WA.
  • Chandrakantan A; Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Houston, TX.
  • Chen J; Department of Orthopedics and Sports Medicine, Seattle Children's Hospital.
  • Shah AS; Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA.
J Pediatr Orthop ; 40(10): e990-e993, 2020.
Article in English | MEDLINE | ID: covidwho-766811
ABSTRACT

BACKGROUND:

The COVID-19 pandemic has substantially altered the typical process around performing surgery to ensure protection of health care workers, patients, and their families. One safety precaution has been the implementation of universal preoperative screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study examines the results of universal screening on children undergoing orthopaedic surgery.

METHODS:

This is a retrospective cohort study evaluating the incidence and symptomatology of COVID-19 in all patients presenting for orthopaedic surgery at 3 pediatric tertiary care children's hospitals during the COVID-19 pandemic (March to June 2020). All patients underwent universal screening with a nasopharyngeal swab to detect presence of SARS-CoV-2. Bivariate and multivariate logistic regression analysis was performed to identify risk factors for positive COVID-19 screening.

RESULTS:

In total, 1198 patients underwent preoperative screening across all 3 institutions and 7 (0.58%) had detection of SARS-CoV-2. The majority of patients (1/7, 86%) were asymptomatic. Patients that tested positive were significantly more likely to be Hispanic (P=0.046) and had greater number of medical comorbidities (P=0.013), as scored on the American Society of Anesthesiologists (ASA) physical status score. A known COVID-19 positive contact was found to be a significant risk factor in the multivariate analysis (P=0.004).

CONCLUSIONS:

Early results of universal preoperative screening for COVID-19 demonstrates a low incidence and high rate of asymptomatic patients. Health care professionals, especially those at higher risk for the virus, should be aware of the challenges related to screening based solely on symptoms or travel history and consider universal screening for patients undergoing elective surgery. LEVEL OF EVIDENCE Level II.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Preoperative Care / Infection Control / Coronavirus Infections / Orthopedic Procedures / Pandemics / Betacoronavirus / Diagnostic Screening Programs Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Child / Female / Humans / Male Country/Region as subject: North America Language: English Journal: J Pediatr Orthop Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Preoperative Care / Infection Control / Coronavirus Infections / Orthopedic Procedures / Pandemics / Betacoronavirus / Diagnostic Screening Programs Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Child / Female / Humans / Male Country/Region as subject: North America Language: English Journal: J Pediatr Orthop Year: 2020 Document Type: Article