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Covid-19 Infection Risk Following Elective Arthroplasty and Surgical Complications in Covid-19-Vaccinated Patients: A Multicenter Comparative Cohort Study Publisher



Mirghaderi SP1, 2 ; Salimi M1 ; Moharrami A1 ; Hosseinidolama R1, 2 ; Mirghaderi SR1 ; Ghaderi M3 ; Motififard M4 ; Mortazavi SMJ1
Authors
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Authors Affiliations
  1. 1. Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Department of Orthopedic Surgery, Kashani University Hospital, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Arthroplasty Today Published:2022


Abstract

Background: We aimed to determine symptomatic Coronavirus disease 2019 (COVID-19) rates within 1 month of elective arthroplasty for vaccinated individuals and to determine whether vaccination guarantees protection against COVID-19 after arthroplasty (primary outcome). In addition, the 90-day surgical complications were compared to those of an unvaccinated group (secondary outcome). Methods: A prospective cohort study was conducted on elective joint arthroplasty patients at 3 tertiary hospitals in 2 major cities (Tehran and Isfahan) in our country (Iran). The outcomes of the COVID-19-vaccinated group were assessed between October 2021 and March 2022. Ninety-day surgical complications were compared with a historical cohort of unvaccinated patients treated earlier in the pandemic (April 2020-March 2021). Results: The study included 1717 consecutive patients: 962 vaccinated and 755 unvaccinated. In the vaccinated group, 38 patients (3.9%) contracted COVID-19, 4 (10.5%) were hospitalized again, and none required intensive care unit admission. The multivariate logistic regression analysis revealed that COVID-19-positive cases are more likely to be female (odds ratio [OR] = 12.5), to have visitors to their home (OR = 4.7), and to stay longer in the hospital (OR = 1.2) than COVID-19-negative cases. Compared to unvaccinated patients, the postoperative COVID-19 rate was not significantly different (3.9% vs 2.4%, P = .07). The incidence of surgical complications was similar between the 2 groups (P > .05). Conclusions: The vaccination does not provide a guarantee that a patient will not contract COVID-19 following their arthroplasty surgery, especially in a region with a high rate of COVID-19. We believe reasonable perioperative COVID-19 precautions may be warranted even in vaccinated patients. © 2022 The Authors
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