No difference in length of stay for patients with and without COVID-19 infection history
In a large single-center study, patients with COVID-19 infection history who had elective TJR during the pandemic did not differ from patients without COVID-19 history for mean length of hospital stay or in-hospital complication rate.
Andy O. Miller, MD, presented the results at the Musculoskeletal Infection Society Annual Meeting.
He and his colleagues at Hospital for Special Surgery studied the impact of a previous infection with SARS-CoV-2 on primary elective total joint replacement. The researchers focused on preoperative IgG antibody test results in 5,354 patients who were operated on between May 2020 to January 2021.
Overall, the study compared 340 patients with history of COVID-19 to 5,014 patients without history of COVID-19. Within the group of patients who had either a positive RT-PCR test or a positive IgG antibody test for SARS-CoV-2, 42% had a history of COVID-19 symptoms and the duration between symptoms and surgery was an average of 168 days, Miller said.
“While there were no differences with respect to age, sex or comorbidity indices, COVID-19 history patients were more likely to be Black, more likely to be Hispanic, to be obese and be anemic, and somewhat less likely to have a history of rheumatoid arthritis,” he said.
About 43% of patients with a COVID-19 history were obese vs. about 32% without a history. Furthermore, a higher proportion of patients in the study with a COVID-19 history were Black (15%) vs. about 6% of patients without a history, and a higher proportion of patients with a COVID-19 history were Hispanic (8.5%) vs. about 5.4% of patients without a history, according to the abstract.
Researchers found no difference in the use of regional anesthesia or ambulatory surgery between the two cohorts.
Miller said this was the largest known cohort of patients operated on for elective TJR during the pandemic.
“Overall in-hospital complication rate was 0.4% with no significant difference between groups and zero complications in our COVID-19 history cohort,” he said.
When he discussed the study limitations, Miller said it was possible patients with a COVID-19 history were self-selected and healthier than most COVID-19 survivors.
“We did not assess for complications after hospital discharge. We were perhaps underpowered to detect increased risks for relatively rare outcomes. COVID-19 is not a randomly assigned disease, and we are observing associations, but certainly no causation,” Miller said.