Background: The novel COVID-19 disease was presented at first in Wuhan, China, in December 2019. During COVID-19 pandemic, elective surgeries were postponed, and health care facilities and resources were reorganized to provide efficient service for the large number of infected patients with COVID-19. Therefore, approaching trauma patients, who could have had COVID-19, was a challenging issue requiring special considerations and healthcare set up.
Methods: This retrospective cohort study was conducted at Rajaei hospital, the main trauma center of the south of Iran, between March 2020 and August 2020 from the beginning of the COVID-19 pandemic. The COVID-19 infection was considered positive by either positive lung CT scan or PCR test. Trauma-related data such as the mechanism and pattern of trauma and injury, and surgical intervention procedures on the suspicious patients were recorded. Baseline characteristics including age, sex, cigarette smoking, and comorbidities were also collected. Need for ICU admission and mortality rates for the Covid and non-Covid cases were investigated and compared together as outcome variables.
Results: During a six-month period of the pandemic Covid-19, 9248 patients referred to our trauma center. While   222 patients were suspected to have Corona infection, Sixty-four cases were confirmed to be positive that had mean age of 44 years. Among the 64 COVID-19 -positive patients, 33 cases with mean age of 36.4 had orthopaedic injuries. 23 patients underwent surgical treatment due to the orthopaedic injuries. 24 patients were victims of motor vehicle accidents which included 7 cases of pelvic and acetabulum fractures.
The mortality rate of COVID-19 -positive cases were 15.6 % (10 patients out of the 64 cases and COVID-19 negative ones was 10.1 % (16 patients out of 158). The difference was not statistically significant (p.value:0.25). Multivariate analysis of the effect of the baseline and trauma related factors on mortality rate, showed that older age (p. value: 0.001), COVID-19 infection (p. value: 0.033), and surgical procedure (p.value:0.038) were the poor prognostic factors associated with mortality rate.
Conclusion: The mortality rate of trauma patients with COVID-19 positive infection was 15.6 % (10 patients). Older age, COVID-19 infection, and surgical procedure were associated with higher mortality rate.