Abstract
<jats:p>Introduction. Post-COVID-19 infection is associated with long-term immune system changes and persistent systemic inflammation. In patients undergoing total hip replacement, chronic elevation of inflammatory markers poses an additional risk of periprosthetic infection, leading clinicians to delay elective procedures. However, the timescales required for laboratory recovery in this cohort of patients remain poorly understood. Aim: to study the impact of the dynamics of serum markers of inflammation, such as Erythrocyte Sedimentation Rate and C-reactive protein, on the medium-term waiting time for total hip replacement surgery in patients with COVID-19. Materials and methods. The observation group included 48 patients (27 female and 21 male) who had referrals to an orthopedic clinic for hip arthroplasty and had a history of confirmed COVID-19. Patients demonstrated elevated serum inflammatory markers; therefore, surgery was postponed until normalization of these parameters. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels at the time of initial referral were analyzed, along with the interval between the initial referral for arthroplasty and normalization of both indicators. Results. C-reactive protein (CRP) levels were lower in women than in men: 17.2 [12.8–21.2] mg/L versus 21.3 [15.4–27.1] mg/L. Similarly, CRP levels were lower in patients younger than 60 years compared with those aged 60 years and older: 15.3 [11.7–19.3] mg/L versus 24.3 [17.7–32.1] mg/L. Erythrocyte sedimentation rate (ESR) values were higher in women than in men, reaching 38 [30–43] mm/h and 24 [21–37] mm/h, respectively. Younger patients also demonstrated lower ESR values compared with patients aged ≥60 years: 27 [22–39] mm/h versus 38 [32–43] mm/h. The median interval between the initial consultation and hip arthroplasty was 7.5 [6.0–9.5] weeks. A statistically significant moderate positive correlation was identified between CRP and ESR levels (rs = 0.558, p < 0.001), reflecting the inflammatory nature of the elevation of both markers. In addition, significant moderate positive correlations were observed between CRP and the interval to surgery (rs = 0.643, p < 0.001), as well as between ESR and the interval to surgery (rs = 0.634, p < 0.001). Conclusions. In patients who have had COVID-19, elevated serum inflammatory markers as potential predictors of periprosthetic infection may persist for a long time, creating uncertainty regarding subsequent total hip arthroplasty. The development of a clinical model of a patient who has had COVID-19 and requires arthroplasty should be considered from the perspective of probable periprosthetic infection, which requires in-depth study.</jats:p>