key: cord-292156-chmyzmq0 authors: Battiato, Concetto; Berdini, Massimo; Luciani, Pierfrancesco; Gigante, Antonio title: Impact of Coronavirus Disease 2019 (COVID-19) on the epidemiology of orthopedics trauma in a region of central Italy date: 2020-10-02 journal: Injury DOI: 10.1016/j.injury.2020.09.044 sha: doc_id: 292156 cord_uid: chmyzmq0 • Italy is among the most affected countries by COVID-19; • The general lockdown significantly reduced road accident traumas, high energy traumas and sport injuries; • Domestic accidents or fall related traumas do not seem to show any variations. The outbreak of Corona Virus Disease 2019 (COVID-19) has had a deep impact worldwide, Italy was among the most affected countries. [1] Italian government have declared lockdown measures and a closure of shops and businesses since 9th March 2020 to reduce the risk of transmission of the virus. [2] The situation of the contagion due to the epidemic of COVID-19 in Italy on 9th April 2020 reported the following data: 143626 total cases of which 18279 dead, 28470 healed, 96877 positive cases. Of positive cases 32004 were hospitalized in intensive care (ICU) units and COVID-19 wards. In Marche region, where the hospitals mentioned below are located, on 9th April 2020, 3401 total positive cases were reported, of which 1078 were admitted to the wards indicated . [3, 4] Italian National Health Service was faced with a sudden influx of patients needing hospitalization due to the respiratory complication of COVID-19. One of the measures adopted was to reduce as much as possible surgical activity to give priority to trauma and urgent surgery by prohibiting the execution of any elective surgery and outpatient activity. The reasons are to be found in the rationalization of the personnel in favour of emergency departments, ICU and brand new departments used to treat COVID-19 affected patients, and to limit the flow of visitors in the hospital that could be a source of contagion for healthcare staff and patients. Emergency and urgent surgery (orthopedics and others) were guaranted despite epidemic. [1] Comparing the same periods in 2019 and 2020, it can be seen how the COVID-19 outbreak had a relevant impact on orthopedic surgical treatments, its frequency, type of fracture, anatomical location involved. As showed in Table 3 comparing the anatomical locations is confirmed a decrease with equal distribution between upper and lower limb surgical procedures in the two periods. But a stable number is mantained in surgical operations of humerus, elbow and femur. Indeed, all domestic accidents that often cause femur fractures or other fall related injuries which often require surgical treatment, have remained unchanged. [5] [6] [7] [8] The demographics do not reveal huge differences regarding the gender or the average age of the population that underwent surgical treatment in the comparison between the same periods in 2019 and 2020. We recorded also that 2019 waiting time for surgery was around a mean of 4.8 days, with an average stay in ward of about 11 days per patient; in 2020 mean waiting time for surgery was about 2.6 days, with an average stay of about 9 days per patient. This is probably due to the different hospital management implemented during the COVID-19 pandemic period. [9, 10] Summarizing COVID-19 has had an impact on orthopaedics surgery management in public hospitals. Most of the surgeries performed were traumas while urgencies have been delayed, whenever possible. Elective surgery has been abolished during lockdown period. It is also interesting to note that the epidemiology of orthopaedic trauma has decreased with equal distribution between the upper and lower limbs, but fractures of femur, elbow and humerus that often are due to domestic accidents, have remained stable. Finally, there was a decreased duration of both waiting times for surgery and post-operative hospitalization. Future studies with a larger number of patients and a longer observation period are needed to evaluate the real impact of COVID-19 on the epidemiology of orthopedic trauma surgery. 6 The authors declare that there are no conflicts of interest. Tab COVID-19 and Italy: what next? COVID-19 in Italy: impact of containment measures and prevalence estimates of infection in the general population Fractures in older adults. A view of the future? Population-based interventions for the prevention of fall-related injuries in older people Epidemiology of orthopedic trauma admissions in a multispecialty hospital in Warangal-A retrospective study Clinical Practice The changing epidemiology of open fractures in vehicle occupants, pedestrians, motorcyclists and cyclists -ScienceDirect Epidemiology of Orthopaedic Trauma Admissions Over One Year in a District General Hospital in England Surgery in COVID-19 patients: operational directives PELVIS FEMUR KNEE/LEG ANKLE/FOOT HUMERUS/ELBOW WRIST/HAND None.