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Fractures in patients with COVID-19 infection: Early prognosis and management. A case series of 20 patients in a single institution in Lombardy, Northern Italy

Journal of Orthopaedic Trauma Sep 29, 2020

Jannelli E, Castelli A, Ferranti Calderoni E, et al. - Researchers here reported on demographic data, COVID-19 symptoms, laboratory and radiographic examinations, and treatment methods among a case series of 20 patients (16 women and 4 men) hospitalized with a fracture and a diagnosis of COVID-19. Their average age was 82.35 years (range 59–95). All patients (100%) were administered antibiotic therapy, whereas 16 patients (80%) received hydroxychloroquine therapy and 8 (40%) were provided treatment with corticosteroids. Antithromboembolic prophylaxis was received by 18 patients (90%). Lymphopenia was identified in 18 patients (90%). Noninvasive mechanical ventilation was required in all 20 patients (100%). D-dimer and polymerase chain reaction values were high in all patients (100%), whereas increased lactate dehydrogenase was noted in 18 patients (90%). Hospitalization is frequently required for patients with fractures, especially in the lower limbs, making these patients more prone to the risk of COVID-19 infection. There seemed no influence of COVID-19 infection on the fracture pattern in the elderly population but it can result in health deterioration with elevated mortality. No change in the typical symptoms of COVID-19 disease was observed when correlated with a fracture or trauma. A more invasive assisted ventilation is noted to be linked with a poor prognosis. On analyzing the data obtained from the SF-36 score, they noted significantly lower values when compared with those reported in the literature.

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