Comparative outcomes of trauma surgery patients with symptomatic and asymptomatic COVID-19: a retrospective study

Coronavirus disease 2019 (COVID-19) infection has varying clinical effects and trauma patients with COVID-19 have been shown to have worsened outcomes. However, a considerable number of affected patients are asymptomatic at hospital admission. We aimed to compare surgical outcomes of trauma patients with asymptomatic and symptomatic COVID-19. In this retrospective study, data from a trauma center were reviewed from April 2021 to March 2022. All COVID-19 patients admitted to the hospital for trauma treatment were included and categorized into asymptomatic and symptomatic groups. Also, COVID-19 negative patients were selected as controls. Outcomes included ICU admission, postoperative complications, hospital stay, and in-hospital mortality. From a total of 252 trauma patients, 74 COVID-19 positive patients (26 asymptomatic and 48 symptomatic) and 57 COVID-19 negative patients (control) were assessed. Symptomatic patients were older (p < 0.05), had higher body temperature, higher heart rate, more comorbidities, and lower SpO₂ value (p < 0.05). A larger number of symptomatic patients required admission to the ICU (p < 0.05). The level of hematocrit and platelets in asymptomatic patients was the highest (p < 0.05) among groups and the symptomatic patients had higher values of CRP, PT, PTT, INR, BUN, and Cr (p < 0.05). Also, symptomatic patients had higher incidence of postoperative complications and mortality rate (p < 0.05), and prolonged hospital stay (p < 0.05). In the adjusted regression model, symptomatic COVID-19 (risk ratio = 6.79, p = 0.001) and high BUN (risk ratio = 1.02, p = 0.015) increased the risk of postoperative complications and the regression model could predict postoperative complications by AUC of 0.896 (95% CI = 0.982–0.965; p = 0.001). Trauma patients with symptomatic COVID-19 had increased postoperative complications, prolonged length of hospital stay, and mortality rate as compared with asymptomatic group and COVID-19-negative patients. Also, symptomatic disease and high BUN levels increased the risk of postoperative complications following trauma surgery.