COVID-19 diagnosis after TKA, THA associated with increased complications, mortality
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Key takeaways:
- Patients readmitted due to COVID-19 within 90 days after TJA were at the greatest risk for complications.
- Patients with a COVID-19 diagnosis had a mortality rate of 3.51%.
Patients who contract COVID-19 after total joint arthroplasty may be at increased risk for complications, including death, according to published results.
Nathanael D. Heckmann, MD, and colleagues at the Keck School of Medicine of USC studied 712 patients who had primary elective total hip or total knee arthroplasty and then contracted COVID-19 at an average time of 117 days after THA and 128 days after TKA. Researchers also analyzed a matched cohort of 4,272 patients who had TJA with no subsequent COVID-19 diagnosis. Outcomes included non-home discharge, pulmonary embolism (PE), periprosthetic joint infection, sepsis, readmission and mortality.
Researchers found 33.6% of COVID-19-positive patients who underwent THA and 32.5% of COVID-19-positive patients who underwent TKA required readmission within 90 days. Researchers found that discharge to a skilled nursing or acute rehabilitation unit and Black race were associated with readmission after TKA in COVID-19-positive patients.
According to the study, COVID-19 diagnosis was also associated with increased risk of PE after TKA as well as PJI and sepsis after THA.
Patients in the control group had a mortality rate of 0.09%. Patients with a COVID-19 diagnosis had a mortality rate of 3.51% and the mortality rate was 7.94% for patients who were readmitted due to a COVID-19 diagnosis.
“Most importantly, patients who contracted COVID-19 following elective TJA were nearly 39 times more likely to die compared to matched controls,” Heckmann and colleagues wrote in the study. “The importance of these findings cannot be overstated.”
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