Aim This study aims to estimate the risk of acquiring medical complication or death from COVID-19 infection in patients who were admitted for orthopaedic trauma surgery during the peak and plateau of pandemic. Unlike other recently published studies, where patient-cohort included a more morbid group and cancer surgeries, we report on a group of patients who had limb surgery and were more akin to elective orthopaedic surgery. Methods The study included 214 patients who underwent orthopaedic trauma surgeries in the hospital between 12th March and 12th May-2020 when the pandemic was on the rise in the United Kingdom. Data was collected on demographic profile including comorbidities, ASA grade, COVID-19 testing, type of procedures and any readmissions, complications or mortality due to COVID-19. Results There were 7.9% readmissions and 52.9% of it was for respiratory complications. Only one patient had positive COVID-19 test during readmission. 30-day mortality for trauma surgeries was 0% if hip fractures were excluded and 2.8% in all patients. All the mortalities were for proximal femur fracture surgeries and between ASA Grade 3 and 4 or in patients above the age of 70 years. Conclusion This study suggests that presence of COVID-19 virus in the community and hospital did not adversely affect the outcome of orthopaedic trauma surgeries or lead to excess mortality or readmissions in patients undergoing limb trauma surgery. The findings also support resumption of elective orthopaedic surgeries with appropriate risk stratification, patient optimization and with adequate infrastructural support amidst the recovery phase of the pandemic.

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BackgroundThe peak number of admissions to hospital intensive care unit (ICU) for influenza-related complications was higher during the 2015/16 flu season than previous seasons. 1 This coincided with a lower uptake of flu vaccination in targeted groups including the elderly, those clinically at risk and healthcare workers across the UK. 1 This highlights the importance of optimal vaccination uptake in target risk groups. AimsWe aimed to quantify vaccination uptake among over 65s and clinically at risk groups as defined by Public Health England (PHE) in The Green Book. 2 Furthermore, we wanted to evaluate current practice in the management of influenza against national guidelines and its complications, particularly community-acquired pneumonia (CAP) against local guidelines. 3,4 MethodologyElectronic records were interrogated for all influenza-positive ICU patients presenting to Guy's and St Thomas' NHS Foundation Trust (GSTT) between the 2015/16 and 2016/17 winter flu seasons. 97 patients were found to fit the inclusion criteria. Demographic, clinical, laboratory and outcome data were extracted using a standard data collection form. Chapter 19 of The Green Book defined clinically at-risk groups who should be offered annual flu vaccination. 2 Antiviral drug selection was directly taken from national PHE 2016 guidance. 3 Local GSTT guidelines defined diagnostic and management standards for CAP. 4 Key findings> 69/97 (71%) patients featured at least one co-morbidity, which qualified them to receive annual flu vaccination.