Coronavirus Disease 2019 and the Injured Patient: A Multicenter Review

Hakmi, Hazim; Islam, Shahidul; Petrone, Patrizio; Sajan, Abin; Baltazar, Gerard; Sohail, Amir; Goulet, Nicole; Jacquez, Ricardo; Stright, Adam; Velcu, Laura; Divers, Jasmin; Joseph, D’Andrea

doi:10.1016/j.jss.2022.06.068

Cited by 1 publication

(1 citation statement)

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“…Prior multicenter analyses suggest that COVID-19 is associated with worse outcomes for trauma patients regardless of injury type or severity. 38 – 40 We suspect that COVID-19-associated inflammatory response may have played a role in the clinical worsening of some injured patients, particularly those severely injured or undergoing emergency operation and at increased risk for profound inflammation. However, given the unpredictability of COVID-19 severity among the general population, we recommend increase vigilance of trauma patients admitted with COVID-19 and appropriate treatment perhaps in advance of developing severe symptoms.…”

Section: Discussionmentioning

confidence: 99%

Racial Differences and Injury Pattern Variation: Impact of COVID-19 on a Bronx Trauma Center

Kiernan

Salvitti

Baltazar

et al. 2022

The American Surgeon™

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Background New York City (NYC) became the epicenter of the COVID-19 pandemic in 2020. The Bronx, with the highest rates of poverty and violent crime of all NYC boroughs and a large Black and Hispanic population, was at increased risk of COVID-19 and its sequelae. We aimed to identify temporal associations among COVID-19 and trauma admission volume, demographics, and mechanism of injury (MOI). Methods A retrospective review of prospectively collected data was conducted from a Level II trauma center in the Bronx. January 1st–September 30th for both 2019 (Pre-COVID) and 2020 (COVID) were compared. Pre-COVID and COVID cohorts were subdivided into EARLY (March–May) and LATE (June–September) subgroups. Demographics and trauma outcomes were compared. Results Trauma admissions were similar between Pre-COVID and COVID. During COVID, there was an increased percentage of Black patients (Black Hispanic 20.1% vs 15.2% and Black Non-Hispanic 39.4% vs 34.1%, P < .05), younger patients (26–35 years old: 22.6% vs 17.6%, P < .05), and out-of-pocket payors (6.0% vs 1.6%, P < .05). Trauma severity outcomes were mixed—some measures supported increased severity; others showed no difference or decreased severity. During COVID, there was a rise in total penetrating injuries (27.4% vs 20.8%, P < .05), MVC (13.2% vs 7.1, P < .05), and firearm injuries (11.6% vs 6.0%, P < .05). Additionally, during LATE COVID, there was a resurgence of total penetrating, total blunt, MVC, falls, cyclists/pedestrians struck, and firearm injuries. Discussion Our results emphasize MOI variations and racial differences of trauma admissions to a Level II trauma center in the Bronx during COVID-19. These findings may help trauma centers plan during pandemics and encourage outreach between trauma centers and community level organizations following future healthcare disasters.

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Section: Discussionmentioning

confidence: 99%