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. 2025 Apr 13;17(4):e82162.
doi: 10.7759/cureus.82162. eCollection 2025 Apr.

Impact of SARS-CoV-2 Infection on the Outcomes of Trauma Patients at a Level I Trauma Center: An Ambispective Observational Study

Shrikant Manwatkar  1 , Ramesh Vaidyanathan  2 , Narendra Chaudhary  2 , Abhinav Kumar  2 , Pratyusha Priyadarshini  2 , Dinesh Bagaria  2 , Amit Gupta  2 , Sushma Sagar  2 , Subodh Kumar  2 , Biplab Mishra  2
Affiliations

Impact of SARS-CoV-2 Infection on the Outcomes of Trauma Patients at a Level I Trauma Center: An Ambispective Observational Study

Shrikant Manwatkar et al. Cureus. .

Abstract

Introduction: Trauma remained a leading cause of hospital admissions even during the COVID-19 pandemic. Trauma and surgical interventions are known to impair the patient's immune function. Clinically, some asymptomatic COVID-19 patients experienced rapid deterioration following surgery. Surgeons and anesthesiologists need to be aware that acute lung injury caused by COVID-19 could be present preoperatively or may worsen postoperatively. Hence, an ambispective observational study was planned to assess the impact of severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection on trauma patient outcomes.

Aims and objectives: This study aims to evaluate the impact of SARS-CoV-2 infection on the outcomes of trauma patients at a level I trauma center.

Materials and methods: This ambispective observational study was conducted at a level 1 trauma center and included patients admitted under the trauma surgery service in the COVID-19 facility. Their outcomes were compared with those of patients admitted to the non-COVID-19 facility from March 2020 to March 2022.

Results: A total of 2,017 patients were admitted under the Division of Trauma Surgery and Critical Care from March 2020 to March 2022. The mean duration of intercostal drainage (ICD) was significantly longer in SARS-CoV-2-positive trauma patients (7.03 ± 3.69 days) compared to SARS-CoV-2-negative trauma patients (5.28 ± 2.75). Acute respiratory distress syndrome (ARDS) was also more common among SARS-CoV-2-positive trauma patients. Additionally, these patients had a longer hospital stay. Notably, SARS-CoV-2-positive trauma patients who died had a significantly lower average injury severity score (ISS) compared to SARS-CoV-2-negative counterparts.

Discussion: Although the average ISS was lower and the average trauma and injury severity score (TRISS) was higher in SARS-CoV-2-positive trauma patients who died compared to SARS-CoV-2-negative trauma patients, overall mortality rates were comparable between the two groups.

Conclusion: Trauma patients with concomitant SARS-CoV-2 infection had a longer duration of ICD, along with an increased incidence of chest infections and ARDS. A greater proportion of SARS-CoV-2-positive trauma patients required ventilatory support. The mortality observed in SARS-CoV-2-positive trauma patients is likely attributed to the concomitant SARS-CoV-2 infection.

Keywords: covid-19; impact of sars-cov-2; sars cov-2; trauma; trauma mortality.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. The Institute Ethics Committee For Post Graduate Research, All India Institute Of Medical Sciences, Ansari Nagar, New Delhi, 110029 issued approval IECPG-497/23.09.2021, RT-06/28.10.2021. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. CONSORT diagram
Figure 2
Figure 2. Month-wise patient distribution compared with the 2019 (pre-COVID-19) data
Month-wise patient distribution from March 2020 to March 2022 (study period) compared with the data of the previous year, i.e., January 2019 to December 2019 (pre-COVID period). That is why there is no data for January 2020 and February 2020.
Figure 3
Figure 3. Association between SARS-COV-2 infection and mode of injury (MOI)
Manja is a thread coated with finely crushed glass, traditionally used for flying kites in India. However, it has been associated with injuries, particularly when left on roads, where it can cause neck injuries in two-wheeler riders.
See this image and copyright information in PMC

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