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Hunter S, Brown E, Crawford H, Grant C. Epidemiology of childhood bone and joint disease during the COVID-19 pandemic in New Zealand. Infection 2024:10.1007/s15010-024-02356-0. [PMID: 39095668 DOI: 10.1007/s15010-024-02356-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 07/14/2024] [Indexed: 08/04/2024]
Abstract
PURPOSE It is unknown whether social distancing impacts frequency of presentation and severity of childhood bone and joint infection (BJI). In New Zealand, the COVID-19 disease elimination strategy involved strict social isolation policies spanning March 2020-September 2022. Examination of this period may provide insight around risk factors for BJI. METHODS A retrospective review of all patients < 16 years with presumed acute haematogenous osteomyelitis (AHO) or septic arthritis (SA) treated in the Auckland region was performed between 2018 and 2023. Frequency and severity of presentations has been examined before, during, and after periods of social restriction. Severe cases included those with intensive care admission, recurrent infection, or multiple surgeries. Pre-hospital experience, length of stay, and disease outcomes have also been assessed. RESULTS A total of 563 cases met inclusion criteria. Compared to the pre-pandemic period, monthly case averages reduced between April 2020 to September 2022 (10.1 vs. 7.9 cases/month, p = 0.008). Separating cases by causative microbiology shows a statistically significant drop in culture negative and Kingella kingae mediated BJI cases (4.2 vs. 2.9 cases/month, p = 0.006) but not for cases secondary to Staphylococcus aureus and Streptococcus pyogenes (4.2 vs. 3.9 cases/month, p = 0.6). The frequency of severe disease reduced during this period (5.6 vs. 4.1 cases/month, p = 0.01) together with lower rates of recurrent infection (9% vs. 4%, p = 0.03). CONCLUSION The COVID-19 management strategy in New Zealand utilised strict social isolation, mask wearing, and hand hygiene measures to control disease spread between 2020 and 2022. These measures coincided with reduction in frequency and severity of presentations for childhood BJI.
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Affiliation(s)
- Sarah Hunter
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
- Paediatric Orthopaedic Department, Starship Hospital, Grafton Road, Zealand, New Zealand.
| | - Elsie Brown
- Paediatric Orthopaedic Department, Starship Hospital, Grafton Road, Zealand, New Zealand
| | - Haemish Crawford
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Paediatric Orthopaedic Department, Starship Hospital, Grafton Road, Zealand, New Zealand
| | - Cameron Grant
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Child and Youth Health, Starship Hospital, Zealand, New Zealand
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Delbrück H, Lambertz E, Migliorini F, Berger N, Hildebrand F. Influence of COVID-19 pandemic on hospitalisations at a paediatric traumatology department during 2020: a single-centre observational study and comprehensive literature review. Eur J Trauma Emerg Surg 2024; 50:591-601. [PMID: 38286949 PMCID: PMC11035450 DOI: 10.1007/s00068-024-02453-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 01/14/2024] [Indexed: 01/31/2024]
Abstract
PURPOSE The study investigates changes in the injury characteristics of hospitalised children in a paediatric trauma centre during the COVID-19 pandemic. METHODS Data from injured children from the pre-pandemic year 2019 were compared to the pandemic year 2020 using Pearson's chi-squared test and the Mann-Whitney U test. The period of highly restrictive regulations (HRP) was evaluated separately. A comprehensive literature review with defined search terms resulted in a descriptive data synthesis. RESULTS Data from 865 patients indicated reductions in admissions of 5.6% and 54.4% during the HRP. In 2020, the hospitalisation time was longer (2.2 ± 2.7 days in 2019 vs. 2.4 ± 2.6 in 2020, p = 0.045); the proportions of wounds requiring surgical therapy (p = 0.008) and of observational treatments, primarily for mild brain injuries (p = 0.046), were higher; and conservative treatments, primarily for contusions, were lower (p = 0.005). There were no significant changes in age, location of lesions, or frequency of surgical therapy; nor were there differences in the HRP, except for fewer injuries in school and kindergarten (p < 0.001). The literature review summarises the main results of 79 studies. CONCLUSION Limited resources did not alter the indications for surgical therapy. Further studies should examine whether the more common injuries sustained at home were caused by excessive work/childcare demands on parents. Reduced inpatient conservative treatment implies that hospital resources possibly were overused previously. The literature offers answers to many detailed questions regarding childhood injuries during a pandemic and more efficient safe treatment. Registration Ethical committee of RWTH Aachen University EK 22-320; Center for Translational & Clinical Research RWTH Aachen University (CTC-A) 21-430.
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Affiliation(s)
- Heide Delbrück
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.
| | - Ellen Lambertz
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Filippo Migliorini
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany
- Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical University, 39100, Bolzano, Italy
| | - Nina Berger
- Department of Neuromuscular and Paediatric Orthopaedics, Klinikum Dritter Orden München - Nymphenburg, Menzinger Strasse 44, 80638, München, Germany
| | - Frank Hildebrand
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany
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The Advantages of the Zero-COVID-19 Strategy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148767. [PMID: 35886618 PMCID: PMC9317662 DOI: 10.3390/ijerph19148767] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/27/2022] [Accepted: 07/01/2022] [Indexed: 02/01/2023]
Abstract
Introduction: To curb the COVID-19 pandemic, countries across the globe have adopted either a mitigation or anelimination policy, such as the zero-COVID-19 strategy. However, further research is needed to systematically investigate the advantages of the zero-COVID-19 strategy in the literature. To bridge the research gap, this study examines the zero-COVID-19 strategy in terms of its advantages as a global anti-pandemic framework. Methods: A literature review was conducted in PubMed, PsycINFO, and Scopus to locate academic articles that discussed the advantages of the zero-COVID-19 strategy. Braun and Clarke’s thematic analysis approach was adopted to guide the data analysis process. Results: The findings of our study show that the advantages of the zero-COVID-19 strategy range from short-term (e.g., limited virus infections, hospitalizations, and deaths), to medium-term (e.g., reduced presence of other infectious diseases), and long-term (e.g., low incidence of long COVID-19). While local residents mainly leverage these advantages, they also impact the global community (e.g., stable global supply of essentials, such as COVID-19 vaccines). Conclusions: COVID-19 is catastrophic, yet controllable. Our study examined the advantages of the zero-COVID-19 strategy from a nuanced perspective and discussed how these advantages benefit both the local and the global community in pandemic control and management. Future studies could investigate the shortcomings of the zero-COVID-19 strategy, especially its unintended consequences, such as adverse impacts on vulnerable populations’ mental health, so that society could more efficiently, economically, and empathetically capitalize on the potential of the zero-COVID-19 strategy for the betterment of personal and public health.
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Hsu CH, Huang HT, Chen CH, Fu YC, Chou PH, Hsu NC. Global Impact of the COVID-19 Pandemic on Orthopedics and the Implications of Telemedicine: A Systematic Review of the Literature. J Clin Med 2022; 11:jcm11112983. [PMID: 35683371 PMCID: PMC9181233 DOI: 10.3390/jcm11112983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/16/2022] [Accepted: 05/21/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to systematically review the literature on the impact of the coronavirus disease (COVID-19) pandemic on the orthopedics field by focusing on multiple aspects, including orthopedic training and application, performance, work loading, change of practice, research work, and other psychological factors. Published articles were searched using the PubMed database. Articles were selected in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Of 58 studies published between 1 January 2020 and 1 October 2021, 57 peer-reviewed original articles were included. Nearly 90% of students experienced an impact of the pandemic on application. The impact on training stemmed from redeployment rates of 20.9–23.1%. The rate of emergency or outpatient visits decreased from 18% to 58.6%. The rates of all surgeries or emergency surgeries decreased by 15.6–49.4%, while the rates of elective surgeries decreased by 43.5–100%. The rate of work loading ranged from 33% to 66%. Approximately 50–100% of surgeons had a change of practice. A total of 40.5% of orthopedic surgeons experienced mild psychological pressure. Approximately 64% had stopped research participant recruitment. Most of the included studies were conducted in Europe, followed by Asia and North America. It is suggested orthopedic surgeons prepare more sufficient, flexible, and reservable staffing measures, proper preventive strategies and surgical scheduling algorithms, and set up dedicated venues and equipment for routine telemedicine with staff training for virtual teaching or consultations in case of future impacts on orthopedics.
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Affiliation(s)
- Chia-Hao Hsu
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan; (C.-H.H.); (C.-H.C.); (P.-H.C.)
- Department of Orthopedics, Kaohsiung Municipal Ta-Tung Hospital, No. 68, Jhonghua 3rd Rd., Cianjin District, Kaohsiung 80145, Taiwan;
- Department of Orthopedics, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd., Sanmin District, Kaohsiung 80756, Taiwan;
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan
| | - Hsuan-Ti Huang
- Department of Orthopedics, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd., Sanmin District, Kaohsiung 80756, Taiwan;
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan
| | - Chung-Hwan Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan; (C.-H.H.); (C.-H.C.); (P.-H.C.)
- Department of Orthopedics, Kaohsiung Municipal Ta-Tung Hospital, No. 68, Jhonghua 3rd Rd., Cianjin District, Kaohsiung 80145, Taiwan;
- Department of Orthopedics, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd., Sanmin District, Kaohsiung 80756, Taiwan;
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan
| | - Yin-Chih Fu
- Department of Orthopedics, Kaohsiung Municipal Ta-Tung Hospital, No. 68, Jhonghua 3rd Rd., Cianjin District, Kaohsiung 80145, Taiwan;
- Department of Orthopedics, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd., Sanmin District, Kaohsiung 80756, Taiwan;
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan
| | - Pei-Hsi Chou
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan; (C.-H.H.); (C.-H.C.); (P.-H.C.)
- Department of Orthopedics, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd., Sanmin District, Kaohsiung 80756, Taiwan;
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan
| | - Nin-Chieh Hsu
- Department of Internal Medicine, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng District, Taipei 10002, Taiwan
- Correspondence: ; Tel.: +886-2-23123456 (ext. 65130)
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