Impact of COVID-19 pandemic on septic arthritis management: a monocentric retrospective study

Abstract

Objective: This study aimed to assess the impact of COVID-19 pandemic on the incidence and management of septic arthritis in a tertiary rheumatology department. Patients and Methods: This retrospective monocentric study included patients hospitalized for septic arthritis between January 2018 and December 2021. Patients were divided into two groups: G1 (patients hospitalized before the pandemic: 2018-2019), and G2 (patients hospitalized during the COVID-19 pandemic: 2020-2021). Septic arthritis incidence was calculated for both groups, risk factors, clinical, paraclinical, therapeutic data were compared between the two periods. Patients who developed COVID-19 in G1 were identified. Results: Twenty-two patients with septic arthritis were included: G1 (n = 7), G2 (n = 15). The incidence rate of septic arthritis was significantly higher during the COVID-19: 3.8/100 patient-years [0.87-3.06] IC 95% vs. 1.8/100 patient-years [0.87-3.06] IC 95%. No significant differences were observed in comorbidities or risk factors for septic arthritis between the two groups. During the pandemic, diagnosis delay and prior use of antibiotics were more significant: 15 [7-30] vs. 5 [3-7] days (p = 0.04) and 60% vs. 14.3% (p = 0.04). However, hospital Length of Stay and duration of antibiotic therapy were statistically comparable. Only G2 reported synovectomy and were transferred to intensive care unit (ICU). COVID-19 was detected only in two patients from G1. Conclusions: The higher incidence of septic arthritis in Group 2 suggests a potential impact of the pandemic on immunity. However, this hypothesis still requires confirmation. Additionally, significant diagnosis delay and prior use of antibiotics during the era of COVID-19 suggest that patients with septic arthritis encountered difficulties in accessing healthcare services during the lockdown.

Keywords

• septic arthritis
• covid-19
• pandemic