- Clinical characteristics, comorbidities, specimen contamination, history of coronavirus disease-19, and clinical courses.
| Case No. | Department | Chief complaint | Comorbidities | Head/facial trauma | Specimen contamination by blood* | COVID-19 history | Pulmonary symptoms | Isolation period** |
|---|---|---|---|---|---|---|---|---|
| 1 | ER | Low abdominal pain | None | None | - | None | None | 4 hours |
| Final diagnosis: pelvic inflammatory disease. Outcomes: outpatient follow-up without hospitalization. | ||||||||
| 2 | ER | Decreased mentality (semicoma) | Hypertension Cerebral aneurysm | None | - | None | None | 5.5 hours |
| Final diagnosis: Lt. middle cerebral artery aneurysm rupture. Outcomes: after confirming the negative COVID-19 result of the real-time RT-PCR test, aneurysm coiling and aneurysm clipping with decompressive craniectomy were carried out; expired on POD11 (surgical delays***: 4 hours). | ||||||||
| 3 | ER | Chest pain, fever | Total thyroidectomy state (due to thyroid cancer; TFT: n-s) | None | - | Recovered COVID-19 patient (isolation lifted 6 days ago) | Mild dyspnea | 4 hours |
| Final diagnosis: R/O chostochondritis. Outcomes: outpatient follow-up without hospitalization. | ||||||||
| 4 | Trauma center | TA (bicyclists),chest pain | None | Facial abrasion | Not reported | None | Mild dyspnea | 13 hours |
| Final diagnosis: facial abrasion; Rt. 6-9th rib fx.; Rt. minimal pneumothorax. Outcomes: after admission, conservative treatment was carried out; discharged after 3 days | ||||||||
| 5 | Trauma center | Crushing injury | None | Panfacial fx. | Bloody sample | None | Dyspnea | 5 hours |
| Final diagnosis: panfacial fracture; Lt. upper arm amputation; Lt. 1-7th rib fx.; Lt. scapular fracture. Outcomes: after confirming the negative COVID-19 result of the confirmatory rRT-PCR test, Lt. arm wound closure was carried out; open reduction and internal fixation were carried out for pan facial fracture, scapular fracture, and rib fracture; discharged on POD26 (surgical delays: 5.5 hours). | ||||||||
| 6 | ER | Dyspnea | Uncontrolled hypertension, ESRD on HD, A-fib, and CHF | None | - | Recovered COVID-19 patient (isolation lifted 14 days ago) | Dyspnea | one day |
| Final diagnosis: CHF exacerbation (EF 50%->20%) and pulmonary edema. Outcomes: after emergency hemodialysis, cardiopulmonary function recovered; discharged after 4 days | ||||||||
| 7 | ER | Preterm labor | Intrauterine pregnancy (30weeks) | None | - | Recovered COVID-19 patient (isolation lifted 8 days ago) | None | one day |
| Final diagnosis: preturm labor. Outcomes: emergency vaginal delivery was carried out in the ER; discharged after 2 days | ||||||||
| 8 | ER | Decreased mentality (drowsy) | Mental retardation, bipolar disorder | None | - | Recovered COVID-19 patient (isolation lifted 45 days ago) | None | one day |
| Final diagnosis: catatonia. Outcomes: hospitalization and medication change, discharged after 29 days | ||||||||
| 9 | Trauma center | TA (pedestrian), decreased mentality (stupor) | DM | Skull fx. | Not reported | None | None | 3 hours |
| Final diagnosis: traumatic SAH and SDH; multiple skull fx. Outcomes: after confirming positive rapid rRT-PCR test results, craniectomy was carried out in the negative pressure operating room with protective equipment (PAPRs), expired on POD3 (surgical delays: none). | ||||||||
| 10 | ER | Desaturation (SpO2 50%, room air) | Tracheostomy state for management of COVID-19 ARDS (33 days ago) | None | - | Recovered COVID-19 patient (isolation lifted 9 days ago) | Desaturation | 13 hours |
| Final diagnosis: tracheostomy associated pneumonia. Outcomes: removes secretions by suctioning the tracheostomy tube. After desaturation improved, the patient was transferred to a community hospital. | ||||||||
| 11 | Trauma center | TA (motorcyclist), cardiac arrest. | None | Skull and panfacial fx. | Bloody sample | None | None | 20 hours |
| Final diagnosis: traumatic SAH and SDH; skull fx.; panfacial fx.; Rt. pneumothorax; Rt. femur fx. Outcomes: after one cycle of CPR, the patient had a return of spontaneous circulation. Without confirming the rapid rRT-PCR test results, decompressive craniectomy was carried out in a negative pressure operating room after wearing PAPRs; expired on POD1 (surgical delays: none). | ||||||||
| 12 | Trauma center | Drunken state, glass laceration injuries on both arm and abdomen. | None | None | Not reported | None | None | 5 hours |
| Final diagnosis: glass laceration injuries on both upper arm and abdomen. Outcomes: after confirming the negative COVID-19 result of the confirmatory rRT-PCR test, wound closure was carried out; discharged on POD7 (surgical delays: 5 hours). | ||||||||
↵* Whether sample contamination by blood was documented in the clinical laboratory footnote for patients with physical injury or trauma.
↵** Total isolation period for COVID-19 in our hospital.
↵*** Total delay in surgical intervention due to false-positive results in rapid rRT-PCR for COVID-19. ER: emergency room, POD: postoperative day, TFT: thyroid function test, n-s: nonspecific findings, R/O: rule out, TA: traffic accident, fx: fracture, ESRD: end-stage renal disease, HD: hemodialysis, CHF: chronic heart failure, EF; ejection fraction, DM; diabetes mellitus, rRT-PCR: real-time reverse-transcription polymerase chain reaction, SAH: subarachnoid hemorrhage, SDH: subdural hemorrhage, PAPR: powered air purifying respirator, ARDS: acute respiratory distress syndrome, SpO2: percutaneous arterial oxygen saturation