Asymptomatic or mildly symptomatic COVID-19 patients with craniomaxillofacial injuries have an increased risk of surgical site infection
Issued Date
2022-10-01
Resource Type
ISSN
02664356
eISSN
15321940
Scopus ID
2-s2.0-85134854041
Pubmed ID
35927146
Journal Title
British Journal of Oral and Maxillofacial Surgery
Volume
60
Issue
8
Start Page
1118
End Page
1124
Rights Holder(s)
SCOPUS
Bibliographic Citation
British Journal of Oral and Maxillofacial Surgery Vol.60 No.8 (2022) , 1118-1124
Suggested Citation
Pitak-Arnnop P., Tangmanee C., Muangchan C., Meningaud J.P., Neff A. Asymptomatic or mildly symptomatic COVID-19 patients with craniomaxillofacial injuries have an increased risk of surgical site infection. British Journal of Oral and Maxillofacial Surgery Vol.60 No.8 (2022) , 1118-1124. 1124. doi:10.1016/j.bjoms.2022.05.009 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/84426
Title
Asymptomatic or mildly symptomatic COVID-19 patients with craniomaxillofacial injuries have an increased risk of surgical site infection
Other Contributor(s)
Abstract
The aim of this paper was to evaluate the association between ‘asymptomatic or mildly symptomatic’ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (AS/MS-COVID) and surgical site infection (SSI) after repair of craniomaxillofacial injury (CMFI). Using a case-control study design with a match ratio of 1:4, we enrolled a cohort of AS/MS-COVID cases with immediately treated CMFI during a one-year period. The main predictor variable was SARS-CoV-2 infection (yes/no), and the outcome of interest was SSI (yes/no). The other variables were demographic, clinical, and operative. Appropriate statistics were computed, and p<0.05 was considered statistically significant. The study group comprised 257 cases (28.8% female; 13.2% aged ≥ 60 years; 10.5% with fractures; 39.7% with involvement of nasal/oral/orbital tissue [viral reservoir organs, VROs]; 81.3% with blunt trauma; 19.1% developed an SSI [vs 6.8% in the control group]) with a mean (SD) age of 39.8 (16.6) years (range 19–87). There was a significant relation between SARS-CoV-2 infection and SSI events (p<0.0001; odds ratio 3.22; 95% confidence interval 2.17 to 4.78). On subgroup analysis, SSIs significantly increased with age ≥ 60 years, presence and treatment of fracture, contact with VROs, and prolonged antibiotic use (PAU). However, multivariate logistic regression analysis confirmed a positive effect only from old age, contact with VROs, and PAU (relative risk = 1.56, 2.52, and 2.03, respectively; r = 0.49; p = 0.0001). There was a significant 2.8-fold increase in SSIs among AS/MS-COVID cases, especially in those aged ≥ 60 years, or those with injuries to VROs, or both, who therefore required PAU.