Management of Traumatic Spinal Fracture in Patient with Coronavirus Disease 2019

Dear Editor,

We found that the article on “Management of traumatic spinal fracture in the coronavirus disease 2019 situation” is very interesting. Sornsa-Ard et al. [1] recommended protocols from Thailand for management of the patients. Thailand is the second country that coronavirus disease 2019 (COVID-19) exists and there is already at least one case of COVID-19 in the patient with spine fracture according to local Thai Centers for Disease Control and Prevention report [2]. In that case, the patient is a foreigner with history of road accident and there is no symptom of fever or respiratory disease at initial presentation. Regarding the algorithm, the recommended is based on the assumption that there is already diagnosed spine fracture. Nevertheless, the patient might firstly present with only a history of traumatic injury. An important forgotten issue is the self-prevention of surgeon. It is possible that the COVID-19 might be asymptomatic during the time of diagnosis of spine fracture. The algorithm can result in missed diagnosis. We should recommend that the universal precautions should be used in surgical management of any patients during COVID-19 outbreak crisis.