A look at the global impact of SARS CoV-2 on orthopedic services

Abstract

Background The COVID-19 pandemic profoundly impacted healthcare institutions worldwide. Particularly, orthopedic departments had to adapt their operational models. Purpose This review aimed to quantify the reduction in surgical and outpatient caseloads, identify other significant trends and ascertain the impact of these trends on orthopedic residency training programs. Methods Medline and Embase were searched for articles describing case load for surgeries, outpatient clinic attendance, or emergency department (ED) visits. Statistical analysis of quantitative data was performed after a Freeman-Tukey double arcsine transformation. Results were pooled with random effects by DerSimonian and Laird model. When insufficient data was available, a systematic approach was used to present the results instead. Results A total of 23 studies were included in this study. The number of elective surgeries, trauma procedures and outpatient attendance decreased by 80% (2013/17400, 0.20, CI: 0.12 to 0.29), 47% (3887/17561, 0.53, CI: 0.37 to 0.69) and 63% (84174/123967, 0.37, CI: 0.24 to 0.51) respectively. During the pandemic, domestic injuries and polytrauma increased. Residency training was disrupted due to diminished clinical exposure and changing teaching methodologies. Additionally, residents had more duties which contributed to a lower quality of life. Conclusions The COVID-19 pandemic has made an unprecedented impact on orthopedics departments worldwide. The slow return of orthopedic departments to normalcy and the compromised training of residents due to the pandemic points to an uncertain future for healthcare institutions worldwide, wherein the impact of this pandemic may yet still be felt far in the future.

Impact of the 1st and 2nd Wave of the COVID-19 Pandemic on Primary or Revision Total Hip and Knee Arthroplasty—A Cross-Sectional Single Center Study

“…Moreover, our center followed the guidelines from the European Society of Sports Traumatology, Knee Surgery, and Arthroscopy (ESSKA) for resumption of orthopedic services. Elective surgery should be performed in COVID-free facilities, hospital stay should be as short as possible, and surgeries should be postponed at the slightest suspicion of a SARS-CoV-2 infection [ 21 , 22 ]. Furthermore, safety guidelines, such as patient and staff weekly testing strategies, as well as the mandatory use of filtering facepiece masks (FFP-2) throughout the facilities were implemented.…”

The Global Effect of the COVID-19 Pandemic on STEMI Care: A Systematic Review and Meta-analysis

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The COVID-19 pandemic has overwhelmed all levels of medical services in many countries with a substantial strain on health care personnel and medical resources. 1 An integrated network of emergency medical services, emergency departments (EDs), referring hospitals, and percutaneous coronary intervention (PCI)-capable hospitals is vital in ST-segment elevation myocardial infarction (STEMI) care to ensure timely reperfusion for patients with STEMI, especially during the pandemic. 2 Although primary PCI is the standard reperfusion strategy during the pandemic as recommended by major guidelines, 3 performing such high-risk procedures on patients with confirmed or unknown COVID-19 status will put health care workers and other patients at risk of transmission.

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Changes in Pediatric ICU Utilization and Clinical Trends During the Coronavirus Pandemic

“…Transmission of common viral infections and incidence of accidental trauma may have decreased due to these measures. [10][11][12][13] However, children's health may have been negatively affected by reduced access to school-based nutritional and health services, postponement of elective surgical procedures, and delays in seeking care. Psychosocial stressors may have led to an increase in child abuse, intentional ingestions, and suicide attempts.…”