Experience of Orthopedic Surgeons Managing COVID Patients at the Peak of Second Wave in a COVID-dedicated Hospital: A Guidance for Future Waves

Abstract

Introduction: The second wave of the severe acute respiratory syndrome coronavirus-2 pandemic in April 2021 had a sudden deluge of moderate to severe patients getting admitted to the orthopedics block, due to scarcity of beds in the medical wards, high dependency and intensive care areas of the hospital. This study is an analysis of these patients managed in the orthopedics block by orthopedic surgeons, which may be useful to formulate guidelines for the management of patients in future waves of the coronavirus disease 2019 (COVID-19) pandemic. Methods: The data of patients were collected by orthopedic residents from the Google sheet which was uploaded daily as part of the hospital data. The data from Google sheet were downloaded and compiled into an excel workbook and analyzed for patient progress, outcome, comorbidities, treatment given, oxygen management, and death analysis. Results: The data of 319 patients admitted from April 17, 2021 to May 20, 2021 in orthopedic block depicted successful recovery and discharge of 160 patients, worsening and transfer to higher wards for 126 patients and 33 deaths. The average age of these patients was 53.43 years with male preponderance (71% male). At the time of admission, 78.05% were reverse transcription polymerase chain reaction/rapid antigen test positive and 21.9% were COVID suspects. The patient’s disease status on arrival was found to be mild in 21.3%, moderate in 43.8%, and severe in 34.7%. The most common comorbidity was hypertension in 39 patients followed by diabetes in 29 patients. The average number of days of hospital stay was 5.48 days. Conclusion: Medical professionals other than critical care medicine can be frontline care providers who can guide the ancillary departments at the peak of pandemic waves. Adherence to the standard operating protocols and interdepartmental coordination need to be effectively managed. This study can be used to formulate guidelines for further improvement in COVID patient care in case of future waves of this pandemic.

Keywords

• coronavirus infection
• coronavirus pandemic
• covid-19
• orthopedic surgeons
• public health