Asymptomatic Covid-19 Trauma Patients Have Worse Outcomes and Resource Utilization: A Matched Cohort Study

Abstract

Objective: To evaluate the impact of COVID-19 positivity on outcomes and resource utilization in the trauma population.

Introduction: COVID-19 infection worsens outcomes of trauma patients, but it is not known if asymptomatic COVID-19 trauma patients have different outcomes from COVID-19-negative patients.

Methods: All trauma patients admitted to an urban level 1 trauma center between March 2020 and October 2021 were collected and reviewed for COVID-19 status. COVID-19-positive patients with symptoms or initial chest radiographs consistent with infections were excluded. Propensity score model 1:3 matched asymptomatic COVID-19-positive to COVID-19-negative trauma patients for their age, body mass index, MOA, injury severity score, SBP<90, GCS<9, and comorbidities. Outcomes included mortality, complications, and resource utilization.

Results: A total of 185 asymptomatic COVID-19-positive patients were matched with 554 COVID-19-negative patients. Asymptomatic COVID-19 -positive patients had higher rates of myocardial infarction and cardiac arrest (3.2% vs. 0.9%, P =0.023), higher ventilator days (3.33 vs. 1.49 days, P <0.001), ICU-length of stay [LOS (4.92 vs. 3.41 d, P =0.034)], overall LOS (11.41 vs. 7.24 d, P <0.001), and hospital charges ($ 176.505.80 vs. 107.591.93, P =0.002).

Conclusion: Asymptomatic COVID-19 trauma patients have significantly higher rates of cardiac events, longer LOS, and higher hospital charges when compared with similar trauma patients who are COVID-19-negative.