Experiences from a non-COVID hub referral orthopedic trauma hospital during the COVID-19 pandemic in Turkey

Background: During the COVID-19 pandemic period, resources should be reorganized to treat the increased burden of COVID-positive patients under the best conditions while simultaneously providing non-deferrable treatment to patients with no suspicion of COVID-19. In this study, we aimed to analyse the trauma patient profile and treatment strategies that emerged in the regional orthopaedic and traumatology hospital during the pandemic period after the implementation of “hub and spoke” organization among the orthopaedic and traumatology clinics.Methods: This cross-observational study was conducted in a training and research hospital in the field of orthopaedics and traumatology that was converted to a non-COVID referral orthopaedic trauma center during the pandemic. Gender, age, length of hospitalization, duration of trauma, place of trauma, severity of trauma, type of admission, type of anaesthesia and site of trauma were evaluated in the patients that presented between March 16 and May 16, 2020.Results: Of the orthopaedic trauma patients requiring surgery, 169 (62.6%) were men and 101 (37.4%) were women. In comparison of the data with that of the last year, significant increases were observed in the number of home traumas (241.5%), low-energy traumas (87.4%), patients referred from other institutions (328.9%), regional anaesthesia patients (124.2%) and patients with hip traumas (226.7%). The length of hospitalization decreased significantly (p<0.05).Conclusions: The creation of hub and spoke organization through the cooperation of orthopaedics and traumatology clinics in the region can reduce the burden on pandemic hospitals by isolating trauma patients requiring orthopaedic surgery who were not suspected of COVID-19 and directing them to dedicated orthopaedics and traumatology hospital

Evaluation of possible COVID-19 reinfection in children: A multicenter clinical study

Background: Although it was originally unknown whether there would be cases of reinfection of coronavirus disease 2019 (COVID-19) as seen with other coronaviruses, cases of reinfection were reported from various regions recently. However, there is little information about reinfection in children. Methods: In this study, we aimed to investigate the incidence and clinical findings of reinfection in pediatric patients who had recovered from COVID-19. We retrospectively evaluated all patients under 18 years of age with COVID-19 infection from a total of eight healthcare facilities in Turkey, between March 2020 and July 2021. Possible reinfection was defined as a record of confirmed COVID-19 infection based on positive reverse transcription-polymerase chain reaction (RT-PCR) test results at least 3 months apart. Results: A possible reinfection was detected in 11 out of 8840 children, which yielded an incidence of 0.12%. The median duration between two episodes of COVID-19 was 196 (92–483) days. When initial and second episodes were compared, the rates of symptomatic and asymptomatic disease were similar for both, as was the severity of the disease (p = 1.000). Also, there was no significant difference in duration of symptoms (p = 0.498) or in hospitalization rates (p = 1.000). Only one patient died 15 days after PCR positivity, which resulted in a 9.1% mortality rate for cases of reinfection in pediatric patients. Conclusion: We observed that children with COVID-19 were less likely to be exposed to reinfection when compared with adults. Although the clinical spectrum of reinfection was mostly similar to the first episode, we reported death of a healthy child during the reinfection