Trauma patients with COVID-19 greater risk of complications, death
Novel coronavirus (COVID-19)-positive patients with traumatic injuries have six times higher risk of death and complication than patients without COVID-19, according to new research by the University of Pennsylvania School of Medicine published in the Journal of Trauma and Acute Care Surgery.
For the study, researchers conducted a retrospective study of 15,550 patients admitted to Pennsylvania trauma centers from March 21, 2020 to July 31, 2020. Of the 15,550 patients, 8,170 were tested for the virus, and 219 tested positive. During this period, the researchers evaluated length of stay, complications, and overall outcomes for patients who tested positive for COVID-19, compared to patients who did not have the virus. They found that rates of testing increased over time, from 34 percent in April 2020 to 56 percent in July. Rates of testing varied substantially across centers, however, with a median of 56.2 percent and a range of 0 percent to 96.4 percent, according to the study.
The researchers found that patients in trauma centers across the state of Pennsylvania who also tested positive for COVID-19 had six times higher risk of death than patients with similar injuries without COVID-19. COVID-19-positive patients also demonstrated double the likelihood of complications such as venous thromboembolism, renal failure, need for intubation, and unplanned intensive care unit (ICU) admission, as well as more than five times the odds of pulmonary complications. These risks were even greater in patients over age 65.
"COVID-19 had the largest impact on patients whose injuries were relatively minor, and who we would have otherwise expected to do well," said Elinore Kaufman, MD, MSHP, lead author of the study and an assistant professor in the Division of Trauma, Surgical Critical Care, and Emergency Surgery at the University of Pennsylvania School of Medicine, in a statement. "Our findings underscore how important it is for hospitals to consistently test admitted patients, so that providers can be aware of this additional risk and treat patients with extra care and vigilance."