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      COVID-19 Infection Risk, Elective Arthroplasty and Surgical Complications and COVID-19 Vaccination: Correspondence

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          Abstract

          Dear Editor, we would like to discuss " COVID-19 Infection Risk Following Elective Arthroplasty and Surgical Complications in COVID-19 Vaccinated Patients: A Multicenter Comparative Cohort Study [1].” The immunization, according to Mirghaderi et al., does not guarantee that a patient would not get COVID-19 following arthroplasty surgery, especially in an area with a high risk of COVID-19. We believe that moderate COVID-19 measures may be necessary even in vaccinated patients [1]. We can all agree that providing a COVID-19 vaccine is a fantastic idea. Several factors, such as the vaccinee's past co-morbidity, the kind of COVID-19, the manner of vaccine administration, and the local epidemiology of SARS-CoV-2, are examples. In the absence of clinical signs, the prevalent occurrence of asymptomatic COVID-19 could also be a role [2]. Testing is frequently skipped to rule out a previous, asymptomatic COVID-19 infection. Only having a history of previous illnesses is insufficient. Laboratory testing must be performed as needed. To better identify the underlying immunological difficulties that a vaccine recipient is experiencing, certain laboratory testing should be used. Examining the underlying immunological abnormalities of vaccination recipients on a regular basis helps one to forecast the efficacy of the COVID-19 vaccine. . This is an important consideration when determining the efficacy or safety of a vaccination. Despite the fact that data on pre-vaccination health or immunological status are occasionally lacking, various clinical articles have demonstrated the efficacy, safety, or clinical significance of the COVID-19 vaccine. Furthermore, the possibility of cross-contamination with an undetected SARS-Co-V2 infection cannot be completely eliminated. Another recent study [3] discovered a relationship between inherited genetic variation and vaccine recipients' immunological reaction. If additional research is planned, the impact of the genetic polymorphism should be assessed. Conflict of interest none

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          Is Open Access

          Letter to the Editor: Coronavirus Disease 2019 (COVID-19), Infectivity, and the Incubation Period

          Dear Editor, We read with great interest the recent publication entitled “A Chinese case of coronavirus disease 2019 (COVID-19) did not show infectivity during the incubation period: based on an epidemiological survey” [1]. Bae concluded that “the epidemiological findings support the claim that the COVID-19 virus does not have infectivity during the incubation period [1].” In fact, a pathogen should not have infectivity during the incubation period or development of disease. However, the exact incubation period of COVID-19 is still unknown. In a recent report by Linton et al. [2], the incubation range was estimated as between 2 days and 14 days with 95% confidence. Exceptional cases might occur with an unusually short or long incubation period. Nevertheless, the reliability of history-taking should also be addressed. How the author was able to confirm the reliability of the patient’s self-reported history is an interesting issue for further discussion. In our country, Thailand, it is not uncommon for patients to disguise their clinical history, which can cause delays in the diagnosis of COVID-19 and exacerbate the local transmission of the disease.
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            GNB3 c.825c>T polymorphism influences T-cell but not antibody response following vaccination with the mRNA-1273 vaccine

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              COVID-19 Infection Risk Following Elective Arthroplasty and Surgical Complications in COVID-19 Vaccinated Patients: A Multicenter Comparative Cohort Study

              Background We aimed to determine symptomatic COVID-19 rates within one month of elective arthroplasty for vaccinated individuals and to determine whether vaccination guarantees protection against COVID-19 after arthroplasty (Primary outcome). In addition, the 90-day surgical complications were compared to an unvaccinated group (secondary outcome). Methods A prospective cohort study was conducted on elective joint arthroplasty patients at three tertiary hospitals in two major cities in our country. The outcomes of the COVID-19 vaccinated group were assessed between October 2021 and March 2022. 90-day surgical complications were compared with a historical cohort of unvaccinated patients treated earlier in the pandemic (April 2020 to March 2021). Results The study included 1717 consecutive patients: 962 vaccinated and 755 unvaccinated. In the vaccinated group, 38 patients (3.9%) contracted COVID-19, four (10.5%) were hospitalized again, and none required Intensive care unit (ICU) admission. Multivariate logistic regression analysis revealed that COVID-19 positive cases are more likely to be female (OR = 12.5), had visitors to the home (OR = 4.7), and longer stays in the hospital (OR = 1.2) than COVID-19 negative cases. Compared to unvaccinated patients, the postoperative COVID-19 rate was not significantly different (3.9% vs. 2.4%, P = 0.07). The incidence of surgical complications was similar between the two groups (P > 0.05). Conclusions The vaccination does not provide a guarantee that a patient will not contract COVID-19 following their arthroplasty surgery, especially in a region with a high rate of COVID-19. We believe reasonable COVID-19 precautions peri-operatively may be warranted even in vaccinated patients.
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                Author and article information

                Journal
                Arthroplast Today
                Arthroplast Today
                Arthroplasty Today
                Published by Elsevier Inc. on behalf of The American Association of Hip and Knee Surgeons.
                2352-3441
                4 November 2022
                4 November 2022
                Affiliations
                [1 ]Private Academic Consultant, Bangkok, Thailand
                [2 ]Adjunct professor, University Centre for Research & Development Department of Pharmaceutical Sciences, Chandigarh University Gharuan, Mohali, Punjab, India
                Author notes
                []Corresponding author; Rujittika Mungmunpuntipantip, Private Academic Consultant, Bangkok, Thailand
                Article
                S2352-3441(22)00241-2
                10.1016/j.artd.2022.10.014
                9633623
                008d04c7-47f9-4874-8769-5947b9cda1ad
                © 2022 Published by Elsevier Inc. on behalf of The American Association of Hip and Knee Surgeons.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 3 October 2022
                : 5 October 2022
                Categories
                Letter to the Editor

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