Customized treatment protocols for patients with closed fracture in hospitals at varying coronavirus disease 2019 (COVID-19) risk

Yu He,Yu He,Xie Xie,Xie Xie,De-Hao Fu,De-Hao Fu,Yong-Guang Wu,Zhong-Hua Guo,Rui Li,Rui Li

doi:10.1186/s12891-021-04614-w

Abstract

BackgroundTo determine an optimized treatment protocol during the COVID-19 epidemic for patients with closed fracture and delayed surgery.MethodsThe epidemic data of three hospitals, randomly selected from different administrative regions of Wuhan, were analyzed retrospectively from 23 January to 31 March 2020. Changes in the number of confirmed cases per day (cumulative and new) of each region were tracked as a reflection of changing epidemic risk levels. The risk level map was drawn. The epidemic status, treatment protocols, and treatment efficiencies for patients with closed fracture in the three hospitals were compared.ResultsOverall, 138 patients with closed fracture were admitted. Each hospital had established its own protocol, according to the initial perceived risk. Based on the risk level map, over the study period, the risk levels of the three regions changed independently and were not in sync. All patients recovered and were timely discharged. No staff member was detected with COVID-19.ConclusionsThe COVID-19 risk level of each area is dynamic. To optimize medical resources, avoid cross-infection, and improve efficiency, changes in epidemic risk should be monitored. For patients with closed fracture, treatment protocols should be adjusted according to changes in epidemic risk.

Highlights

To determine an optimized treatment protocol during the COVID-19 epidemic for patients with closed fracture and delayed surgery
Setting and participants The study was performed based on data collected, for the period from 23 to 2020 to 31 March 2020, from the following three hospitals: Wuhan Union Hospital (H1); People’s Hospital of Dong-Xi-Hu District, Wuhan (H2); and People’s Hospital of Caidian District, Wuhan (H3)
During the 2-week isolation period, two patients and one caregiver were confirmed to have COVID-19 in H1, and three patients were confirmed in H2

Summary

Introduction

To determine an optimized treatment protocol during the COVID-19 epidemic for patients with closed fracture and delayed surgery. The novel coronavirus pneumonia due to SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection was termed coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO) [1]. A postoperative patient with delayed diagnosis of COVID-19 caused the transmission of the disease to 14 of the associated medical personnel in one ward [3]. In 2003 in Canada during the SARS (severe acute respiratory syndrome) epidemic, nine medical staff were infected after exposure to an infected patient in the operating room [4]. During the COVID-19 pandemic, these unfortunate experiences led to a global guideline for limiting elective surgical procedures, in order to reduce the risk of cross-infection, and make medical space and personnel more available for the greater need [5]

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