Usefulness of PCR Screening in the Initial Triage of Trauma Patients During COVID-19 Pandemic.
Identifieur interne : 000084 ( Main/Exploration ); précédent : 000083; suivant : 000085Usefulness of PCR Screening in the Initial Triage of Trauma Patients During COVID-19 Pandemic.
Auteurs : Juan A. Porcel-Vazquez [Espagne] ; Jose V. Andres-Peiro [Espagne] ; Yaiza Garcia-Sanchez [Espagne] ; Ernesto Guerra-Farfan [Espagne] ; Jaume Mestre-Torres [Espagne] ; Joan Minguell-Monyart [Espagne] ; Vicente Molero-Garcia [Espagne] ; Jordi Selga Marsa [Espagne] ; Jordi Tomas-Hernandez [Espagne] ; Maria Del Mar Villar-Casares [Espagne] ; Mohit Bhandari [Canada] ; Jordi Teixidor-Serra [Espagne]Source :
- Journal of orthopaedic trauma [ 1531-2291 ] ; 2020.
Descripteurs français
- KwdFr :
- ARN viral (analyse), Adulte d'âge moyen (MeSH), Betacoronavirus (génétique), Espagne (épidémiologie), Femelle (MeSH), Humains (MeSH), Incidence (MeSH), Infections à coronavirus (diagnostic), Infections à coronavirus (épidémiologie), Mâle (MeSH), Pandémies (MeSH), Plaies et blessures (complications), Plaies et blessures (diagnostic), Plaies et blessures (épidémiologie), Pneumopathie virale (diagnostic), Pneumopathie virale (épidémiologie), Réaction de polymérisation en chaîne (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Techniques de laboratoire clinique (MeSH), Triage (méthodes), Études de suivi (MeSH), Études rétrospectives (MeSH).
- MESH :
- analyse : ARN viral.
- diagnostic : Infections à coronavirus, Plaies et blessures, Pneumopathie virale.
- génétique : Betacoronavirus.
- méthodes : Triage.
- épidémiologie : Espagne, Infections à coronavirus, Plaies et blessures, Pneumopathie virale.
- Adulte d'âge moyen, Femelle, Humains, Incidence, Mâle, Pandémies, Réaction de polymérisation en chaîne, Sujet âgé, Sujet âgé de 80 ans ou plus, Techniques de laboratoire clinique, Études de suivi, Études rétrospectives.
- Wicri :
- geographic : Espagne.
English descriptors
- KwdEn :
- Aged (MeSH), Aged, 80 and over (MeSH), Betacoronavirus (genetics), Clinical Laboratory Techniques (MeSH), Coronavirus Infections (diagnosis), Coronavirus Infections (epidemiology), Female (MeSH), Follow-Up Studies (MeSH), Humans (MeSH), Incidence (MeSH), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (diagnosis), Pneumonia, Viral (epidemiology), Polymerase Chain Reaction (MeSH), RNA, Viral (analysis), Retrospective Studies (MeSH), Spain (epidemiology), Triage (methods), Wounds and Injuries (complications), Wounds and Injuries (diagnosis), Wounds and Injuries (epidemiology).
- MESH :
- chemical , analysis : RNA, Viral.
- geographic , epidemiology : Spain.
- complications : Wounds and Injuries.
- diagnosis : Coronavirus Infections, Pneumonia, Viral, Wounds and Injuries.
- epidemiology : Coronavirus Infections, Pneumonia, Viral, Wounds and Injuries.
- genetics : Betacoronavirus.
- methods : Triage.
- Aged, Aged, 80 and over, Clinical Laboratory Techniques, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Pandemics, Polymerase Chain Reaction, Retrospective Studies.
Abstract
BACKGROUND
Hospitals worldwide have postponed all nonessential surgery during the COVID-19 pandemic, but non-COVID-19 patients are still in urgent need of care. Uncertainty about a patient's COVID-19 status risks infecting health care workers and non-COVID-19 inpatients. We evaluated the use of quantitative reverse transcription polymerase chain reaction (RT-qPCR) screening for COVID-19 on admission for all patients with fractures.
METHODS
We conducted a retrospective cohort study of patients older than 18 years admitted with low-energy fractures who were tested by RT-qPCR for SARS-CoV-2 at any time during hospitalization. Two periods based on the applied testing protocol were defined. During the first period, patients were only tested because of epidemiological criteria or clinical suspicion based on fever, respiratory symptoms, or radiological findings. In the second period, all patients admitted for fracture treatment were screened by RT-qPCR.
RESULTS
We identified 15 patients in the first period and 42 in the second. In total, 9 (15.8%) patients without clinical or radiological findings tested positive at any moment. Five (33.3%) patients tested positive postoperatively in the first period and 3 (7.1%) in the second period (P = 0.02). For clinically unsuspected patients, postoperative positive detection went from 3 of 15 (20%) during the first period to 2 of 42 (4.8%) in the second (P = 0.11). Clinical symptoms demonstrated high specificity (92.1%) but poor sensitivity (52.6%) for infection detection.
CONCLUSIONS
Symptom-based screening for COVID-19 has shown to be specific but not sensitive. Negative clinical symptoms do not rule out infection. Protocols and separated areas are necessary to treat infected patients. RT-qPCR testing on admission helps minimize the risk of nosocomial and occupational infection.
LEVEL OF EVIDENCE
Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
DOI: 10.1097/BOT.0000000000001903
PubMed: 32947588
Affiliations:
Links toward previous steps (curation, corpus...)
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wicri:level="3"><nlm:affiliation>Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Minguell Monyart, Joan" sort="Minguell Monyart, Joan" uniqKey="Minguell Monyart J" first="Joan" last="Minguell-Monyart">Joan Minguell-Monyart</name><affiliation wicri:level="3"><nlm:affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Molero Garcia, Vicente" sort="Molero Garcia, Vicente" uniqKey="Molero Garcia V" first="Vicente" last="Molero-Garcia">Vicente Molero-Garcia</name><affiliation wicri:level="3"><nlm:affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Selga Marsa, Jordi" sort="Selga Marsa, Jordi" uniqKey="Selga Marsa J" first="Jordi" last="Selga Marsa">Jordi Selga Marsa</name><affiliation wicri:level="3"><nlm:affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Tomas Hernandez, Jordi" sort="Tomas Hernandez, Jordi" uniqKey="Tomas Hernandez J" first="Jordi" last="Tomas-Hernandez">Jordi Tomas-Hernandez</name><affiliation wicri:level="3"><nlm:affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Villar Casares, Maria Del Mar" sort="Villar Casares, Maria Del Mar" uniqKey="Villar Casares M" first="Maria Del Mar" last="Villar-Casares">Maria Del Mar Villar-Casares</name><affiliation wicri:level="3"><nlm:affiliation>Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Bhandari, Mohit" sort="Bhandari, Mohit" uniqKey="Bhandari M" first="Mohit" last="Bhandari">Mohit Bhandari</name><affiliation wicri:level="4"><nlm:affiliation>Department of Surgery, McMaster University, Hamilton, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Surgery, McMaster University, Hamilton, ON</wicri:regionArea><orgName type="university">Université McMaster</orgName><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Teixidor Serra, Jordi" sort="Teixidor Serra, Jordi" uniqKey="Teixidor Serra J" first="Jordi" last="Teixidor-Serra">Jordi Teixidor-Serra</name><affiliation wicri:level="3"><nlm:affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" 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Porcel-Vazquez</name><affiliation wicri:level="3"><nlm:affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Andres Peiro, Jose V" sort="Andres Peiro, Jose V" uniqKey="Andres Peiro J" first="Jose V" last="Andres-Peiro">Jose V. Andres-Peiro</name><affiliation wicri:level="3"><nlm:affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Garcia Sanchez, Yaiza" sort="Garcia Sanchez, Yaiza" uniqKey="Garcia Sanchez Y" first="Yaiza" last="Garcia-Sanchez">Yaiza Garcia-Sanchez</name><affiliation wicri:level="3"><nlm:affiliation>Department of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Guerra Farfan, Ernesto" sort="Guerra Farfan, Ernesto" uniqKey="Guerra Farfan E" first="Ernesto" last="Guerra-Farfan">Ernesto Guerra-Farfan</name><affiliation wicri:level="3"><nlm:affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Mestre Torres, Jaume" sort="Mestre Torres, Jaume" uniqKey="Mestre Torres J" first="Jaume" last="Mestre-Torres">Jaume Mestre-Torres</name><affiliation wicri:level="3"><nlm:affiliation>Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Minguell Monyart, Joan" sort="Minguell Monyart, Joan" uniqKey="Minguell Monyart J" first="Joan" last="Minguell-Monyart">Joan Minguell-Monyart</name><affiliation wicri:level="3"><nlm:affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Molero Garcia, Vicente" sort="Molero Garcia, Vicente" uniqKey="Molero Garcia V" first="Vicente" last="Molero-Garcia">Vicente Molero-Garcia</name><affiliation wicri:level="3"><nlm:affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Selga Marsa, Jordi" sort="Selga Marsa, Jordi" uniqKey="Selga Marsa J" first="Jordi" last="Selga Marsa">Jordi Selga Marsa</name><affiliation wicri:level="3"><nlm:affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Tomas Hernandez, Jordi" sort="Tomas Hernandez, Jordi" uniqKey="Tomas Hernandez J" first="Jordi" last="Tomas-Hernandez">Jordi Tomas-Hernandez</name><affiliation wicri:level="3"><nlm:affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Villar Casares, Maria Del Mar" sort="Villar Casares, Maria Del Mar" uniqKey="Villar Casares M" first="Maria Del Mar" last="Villar-Casares">Maria Del Mar Villar-Casares</name><affiliation wicri:level="3"><nlm:affiliation>Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Bhandari, Mohit" sort="Bhandari, Mohit" uniqKey="Bhandari M" first="Mohit" last="Bhandari">Mohit Bhandari</name><affiliation wicri:level="4"><nlm:affiliation>Department of Surgery, McMaster University, Hamilton, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Surgery, McMaster University, Hamilton, ON</wicri:regionArea><orgName type="university">Université McMaster</orgName><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Teixidor Serra, Jordi" sort="Teixidor Serra, Jordi" uniqKey="Teixidor Serra J" first="Jordi" last="Teixidor-Serra">Jordi Teixidor-Serra</name><affiliation wicri:level="3"><nlm:affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author></analytic><series><title level="j">Journal of orthopaedic trauma</title><idno type="eISSN">1531-2291</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Betacoronavirus (genetics)</term><term>Clinical Laboratory Techniques (MeSH)</term><term>Coronavirus Infections (diagnosis)</term><term>Coronavirus Infections (epidemiology)</term><term>Female (MeSH)</term><term>Follow-Up Studies (MeSH)</term><term>Humans (MeSH)</term><term>Incidence (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (diagnosis)</term><term>Pneumonia, Viral (epidemiology)</term><term>Polymerase Chain Reaction (MeSH)</term><term>RNA, Viral (analysis)</term><term>Retrospective Studies (MeSH)</term><term>Spain (epidemiology)</term><term>Triage (methods)</term><term>Wounds and Injuries (complications)</term><term>Wounds and Injuries (diagnosis)</term><term>Wounds and Injuries (epidemiology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>ARN viral (analyse)</term><term>Adulte d'âge moyen (MeSH)</term><term>Betacoronavirus (génétique)</term><term>Espagne (épidémiologie)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Incidence (MeSH)</term><term>Infections à coronavirus (diagnostic)</term><term>Infections à coronavirus (épidémiologie)</term><term>Mâle (MeSH)</term><term>Pandémies (MeSH)</term><term>Plaies et blessures (complications)</term><term>Plaies et blessures (diagnostic)</term><term>Plaies et blessures (épidémiologie)</term><term>Pneumopathie virale (diagnostic)</term><term>Pneumopathie virale (épidémiologie)</term><term>Réaction de polymérisation en chaîne (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Techniques de laboratoire clinique (MeSH)</term><term>Triage (méthodes)</term><term>Études de suivi (MeSH)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="analysis" xml:lang="en"><term>RNA, Viral</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Spain</term></keywords><keywords scheme="MESH" qualifier="analyse" xml:lang="fr"><term>ARN viral</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Wounds and Injuries</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term><term>Wounds and Injuries</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Infections à coronavirus</term><term>Plaies et blessures</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term><term>Wounds and Injuries</term></keywords><keywords scheme="MESH" qualifier="genetics" xml:lang="en"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="génétique" xml:lang="fr"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Triage</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Triage</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Espagne</term><term>Infections à coronavirus</term><term>Plaies et blessures</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Clinical Laboratory Techniques</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Incidence</term><term>Male</term><term>Middle Aged</term><term>Pandemics</term><term>Polymerase Chain Reaction</term><term>Retrospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Incidence</term><term>Mâle</term><term>Pandémies</term><term>Réaction de polymérisation en chaîne</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Techniques de laboratoire clinique</term><term>Études de suivi</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Espagne</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Hospitals worldwide have postponed all nonessential surgery during the COVID-19 pandemic, but non-COVID-19 patients are still in urgent need of care. Uncertainty about a patient's COVID-19 status risks infecting health care workers and non-COVID-19 inpatients. We evaluated the use of quantitative reverse transcription polymerase chain reaction (RT-qPCR) screening for COVID-19 on admission for all patients with fractures.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We conducted a retrospective cohort study of patients older than 18 years admitted with low-energy fractures who were tested by RT-qPCR for SARS-CoV-2 at any time during hospitalization. Two periods based on the applied testing protocol were defined. During the first period, patients were only tested because of epidemiological criteria or clinical suspicion based on fever, respiratory symptoms, or radiological findings. In the second period, all patients admitted for fracture treatment were screened by RT-qPCR.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>We identified 15 patients in the first period and 42 in the second. In total, 9 (15.8%) patients without clinical or radiological findings tested positive at any moment. Five (33.3%) patients tested positive postoperatively in the first period and 3 (7.1%) in the second period (P = 0.02). For clinically unsuspected patients, postoperative positive detection went from 3 of 15 (20%) during the first period to 2 of 42 (4.8%) in the second (P = 0.11). Clinical symptoms demonstrated high specificity (92.1%) but poor sensitivity (52.6%) for infection detection.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Symptom-based screening for COVID-19 has shown to be specific but not sensitive. Negative clinical symptoms do not rule out infection. Protocols and separated areas are necessary to treat infected patients. RT-qPCR testing on admission helps minimize the risk of nosocomial and occupational infection.</p></div><div type="abstract" xml:lang="en"><p><b>LEVEL OF EVIDENCE</b></p><p>Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32947588</PMID><DateCompleted><Year>2020</Year><Month>10</Month><Day>02</Day></DateCompleted><DateRevised><Year>2020</Year><Month>10</Month><Day>02</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1531-2291</ISSN><JournalIssue CitedMedium="Internet"><Volume>34</Volume><Issue>10</Issue><PubDate><Year>2020</Year><Month>10</Month></PubDate></JournalIssue><Title>Journal of orthopaedic trauma</Title><ISOAbbreviation>J Orthop Trauma</ISOAbbreviation></Journal><ArticleTitle>Usefulness of PCR Screening in the Initial Triage of Trauma Patients During COVID-19 Pandemic.</ArticleTitle><Pagination><MedlinePgn>e377-e381</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1097/BOT.0000000000001903</ELocationID><Abstract><AbstractText Label="BACKGROUND">Hospitals worldwide have postponed all nonessential surgery during the COVID-19 pandemic, but non-COVID-19 patients are still in urgent need of care. Uncertainty about a patient's COVID-19 status risks infecting health care workers and non-COVID-19 inpatients. We evaluated the use of quantitative reverse transcription polymerase chain reaction (RT-qPCR) screening for COVID-19 on admission for all patients with fractures.</AbstractText><AbstractText Label="METHODS">We conducted a retrospective cohort study of patients older than 18 years admitted with low-energy fractures who were tested by RT-qPCR for SARS-CoV-2 at any time during hospitalization. Two periods based on the applied testing protocol were defined. During the first period, patients were only tested because of epidemiological criteria or clinical suspicion based on fever, respiratory symptoms, or radiological findings. In the second period, all patients admitted for fracture treatment were screened by RT-qPCR.</AbstractText><AbstractText Label="RESULTS">We identified 15 patients in the first period and 42 in the second. In total, 9 (15.8%) patients without clinical or radiological findings tested positive at any moment. Five (33.3%) patients tested positive postoperatively in the first period and 3 (7.1%) in the second period (P = 0.02). For clinically unsuspected patients, postoperative positive detection went from 3 of 15 (20%) during the first period to 2 of 42 (4.8%) in the second (P = 0.11). Clinical symptoms demonstrated high specificity (92.1%) but poor sensitivity (52.6%) for infection detection.</AbstractText><AbstractText Label="CONCLUSIONS">Symptom-based screening for COVID-19 has shown to be specific but not sensitive. Negative clinical symptoms do not rule out infection. Protocols and separated areas are necessary to treat infected patients. RT-qPCR testing on admission helps minimize the risk of nosocomial and occupational infection.</AbstractText><AbstractText Label="LEVEL OF EVIDENCE">Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Porcel-Vazquez</LastName><ForeName>Juan A</ForeName><Initials>JA</Initials><AffiliationInfo><Affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Andres-Peiro</LastName><ForeName>Jose V</ForeName><Initials>JV</Initials><AffiliationInfo><Affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Garcia-Sanchez</LastName><ForeName>Yaiza</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Guerra-Farfan</LastName><ForeName>Ernesto</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mestre-Torres</LastName><ForeName>Jaume</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Minguell-Monyart</LastName><ForeName>Joan</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Molero-Garcia</LastName><ForeName>Vicente</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Selga Marsa</LastName><ForeName>Jordi</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tomas-Hernandez</LastName><ForeName>Jordi</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Villar-Casares</LastName><ForeName>Maria Del Mar</ForeName><Initials>MDM</Initials><AffiliationInfo><Affiliation>Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bhandari</LastName><ForeName>Mohit</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Surgery, McMaster University, Hamilton, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Teixidor-Serra</LastName><ForeName>Jordi</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Orthop Trauma</MedlineTA><NlmUniqueID>8807705</NlmUniqueID><ISSNLinking>0890-5339</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D012367">RNA, Viral</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Protocol" UI="C000657964">COVID-19 diagnostic testing</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName><QualifierName UI="Q000235" MajorTopicYN="Y">genetics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D019411" MajorTopicYN="N">Clinical Laboratory Techniques</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015994" MajorTopicYN="N">Incidence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="Y">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016133" MajorTopicYN="N">Polymerase Chain Reaction</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012367" MajorTopicYN="N">RNA, Viral</DescriptorName><QualifierName UI="Q000032" MajorTopicYN="Y">analysis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013030" MajorTopicYN="N" Type="Geographic">Spain</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014218" MajorTopicYN="N">Triage</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014947" MajorTopicYN="N">Wounds and Injuries</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>9</Month><Day>18</Day><Hour>20</Hour><Minute>25</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>9</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>10</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32947588</ArticleId><ArticleId IdType="doi">10.1097/BOT.0000000000001903</ArticleId><ArticleId IdType="pii">00005131-202010000-00015</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Canada</li><li>Espagne</li></country><region><li>Catalogne</li><li>Ontario</li></region><settlement><li>Barcelone</li><li>Hamilton (Ontario)</li></settlement><orgName><li>Université McMaster</li></orgName></list><tree><country name="Espagne"><region name="Catalogne"><name sortKey="Porcel Vazquez, Juan A" sort="Porcel Vazquez, Juan A" uniqKey="Porcel Vazquez J" first="Juan A" last="Porcel-Vazquez">Juan A. Porcel-Vazquez</name></region><name sortKey="Andres Peiro, Jose V" sort="Andres Peiro, Jose V" uniqKey="Andres Peiro J" first="Jose V" last="Andres-Peiro">Jose V. Andres-Peiro</name><name sortKey="Garcia Sanchez, Yaiza" sort="Garcia Sanchez, Yaiza" uniqKey="Garcia Sanchez Y" first="Yaiza" last="Garcia-Sanchez">Yaiza Garcia-Sanchez</name><name sortKey="Guerra Farfan, Ernesto" sort="Guerra Farfan, Ernesto" uniqKey="Guerra Farfan E" first="Ernesto" last="Guerra-Farfan">Ernesto Guerra-Farfan</name><name sortKey="Mestre Torres, Jaume" sort="Mestre Torres, Jaume" uniqKey="Mestre Torres J" first="Jaume" last="Mestre-Torres">Jaume Mestre-Torres</name><name sortKey="Minguell Monyart, Joan" sort="Minguell Monyart, Joan" uniqKey="Minguell Monyart J" first="Joan" last="Minguell-Monyart">Joan Minguell-Monyart</name><name sortKey="Molero Garcia, Vicente" sort="Molero Garcia, Vicente" uniqKey="Molero Garcia V" first="Vicente" last="Molero-Garcia">Vicente Molero-Garcia</name><name sortKey="Selga Marsa, Jordi" sort="Selga Marsa, Jordi" uniqKey="Selga Marsa J" first="Jordi" last="Selga Marsa">Jordi Selga Marsa</name><name sortKey="Teixidor Serra, Jordi" sort="Teixidor Serra, Jordi" uniqKey="Teixidor Serra J" first="Jordi" last="Teixidor-Serra">Jordi Teixidor-Serra</name><name sortKey="Tomas Hernandez, Jordi" sort="Tomas Hernandez, Jordi" uniqKey="Tomas Hernandez J" first="Jordi" last="Tomas-Hernandez">Jordi Tomas-Hernandez</name><name sortKey="Villar Casares, Maria Del Mar" sort="Villar Casares, Maria Del Mar" uniqKey="Villar Casares M" first="Maria Del Mar" last="Villar-Casares">Maria Del Mar Villar-Casares</name></country><country name="Canada"><region name="Ontario"><name sortKey="Bhandari, Mohit" sort="Bhandari, Mohit" uniqKey="Bhandari M" first="Mohit" last="Bhandari">Mohit Bhandari</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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