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Archives of Orthopaedic and Traumatic Surgery
Article . 2020 . Peer-reviewed
License: CC BY
Data sources: Crossref
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Assessing the spreading potential of an undetected case of COVID-19 in orthopaedic surgery

Authors: Schneider, K. N.; Correa-Martínez, C. L.; Gosheger, G.; Rickert, C.; Schorn, D.; Mellmann, A.; Schwierzeck, V.; +1 Authors

Assessing the spreading potential of an undetected case of COVID-19 in orthopaedic surgery

Abstract

Abstract Background With the novel coronavirus-induced disease (COVID-19), there is the fear of nosocomial infections and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmissions to healthcare workers (HCW). We report the case of a 64-year-old male patient who underwent explantation of a shoulder prosthesis due to a periprosthetic infection. He was tested SARS-CoV-2 positive 7 days after admission to the orthopaedic department following strict infection control measures, routinely including screening all patients for multi-drug-resistant organism (MDRO) colonization upon admission. Aim of our study is to report on the spreading potential of SARS-CoV-2 in a healthcare setting if standard contact precautions and infection control measures have been established. Methods All HCW with exposure to the patient from day of admission until confirmed diagnosis of COVID-19 were identified and underwent oropharyngeal swab testing for SARS‐CoV‐2 by real-time RT-PCR. Results Sixty-six HCW were identified: nine orthopaedic surgeons, four anaesthesiologists, 25 orthopaedic nurses, five nurse anesthetists, eight scrub nurses, five nursing students, two medical assistants and seven service employees. Fourteen HCW (21%) showed clinical symptoms compatible with a SARS-CoV-2 infection: cough (n = 4), sore throat (n = 3), nasal congestion (n = 3), dyspnea (n = 2), fever (n = 1), headache and myalgia (n = 1). SARS-CoV-2 was not detected in any of the 66 HCW. Conclusion Hygienic measures and contact precautions, aimed at preventing the spread of MRDO, may have helped to prevent a SARS-CoV-2 transmission to HCW—despite high-risk exposure during intubation, surgical treatment and general care. Level of evidence IV, case series.

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Keywords

Male, Infection Control, Risk Management, Shoulder, Infectious Disease Transmission, Patient-to-Professional, Prosthesis-Related Infections, SARS-CoV-2, Health Personnel, COVID-19, General Medicine, Middle Aged, Orthopaedic Surgery, COVID-19 Nucleic Acid Testing, Occupational Exposure, Humans, Orthopedics and Sports Medicine, Surgery, Orthopedic Procedures, COVID-19 ; Occupational Exposure/analysis [MeSH] ; COVID-19 Nucleic Acid Testing/methods [MeSH] ; Infection Control/methods [MeSH] ; Nosocomial ; MDRO ; Prosthesis-Related Infections/surgery [MeSH] ; Occupational Exposure/prevention ; Male [MeSH] ; Shoulder/surgery [MeSH] ; Contact Tracing/methods [MeSH] ; SARS-CoV-2 [MeSH] ; SARS-CoV-2 ; COVID-19/diagnosis [MeSH] ; Infectious Disease Transmission, Patient-to-Professional/prevention ; Orthopaedics ; Device Removal/methods [MeSH] ; Risk Management [MeSH] ; Humans [MeSH] ; Infection Control/organization ; Health Personnel/classification [MeSH] ; Middle Aged [MeSH] ; Infection ; COVID-19/prevention ; COVID-19/transmission [MeSH] ; Orthopaedic Surgery ; Orthopedic Procedures/methods [MeSH] ; Health Personnel/statistics, Contact Tracing, Device Removal

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    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
8
Top 10%
Top 10%
Top 10%
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