الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Background: Corona virus disease 2019 (covid-19) which is caused by the novel severe acute respiratory inflammatory syndrome corona virus (SARS-CoV-2) lead to 21st century first pandemic crisis. First emerged in December, 2019 in China, and has since rapidly spread to become a world-wide pandemic. It affects healthcare system and patient’s morbidity and mortality rate. Orthopaedic surgery suffered a significant decline in the volume of surgical cases, while Emergency operations for proximal femur fractures (PFF) in the elderly population assumed levels comparable to before the pandemic, with the 1-year mortality rate ranging from 14% to 36%.
Objectives: To determine whether patients with proximal femur fractures and concomitant COVID-19 infection have a higher risk of postoperative mortality through a systematic review and meta-analysis.
Patients and Methods: The present systematic review will be performed in accordance with the preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search for all evidence published articles using the online databases MEDLINE, PubMed and Cochrane will be performed. The purpose of this search is to identify all eligible studies featuring co-morbidities and mortality in PFFS patient treated surgically.
Results: among 159 articles that came from the search query and hand-search, 24 studies included, 24 articles were eligible after applying inclusion and exclusion criteria. 15 comparative studies reported mortality for both covid +ve and non covid +ve pts underwent surgical management with total number of 78,486 patients, 569 /2744 covid +ve compared to 3567/75742 non covid +ve pts managed surgically had died. The overall mortality among covid +ve was 20.7% compared to 4.7% non covid +ve. Covid +ve pts had a significant higher mortality rate than non covid +ve pts. (Odds ratio 5.22, 95% CI (3.88-4.9), P value < .00001), and I2 = 27%. Sensitivity test was done without Egol et al., 2020 and show decreased heterogeneity I2 from 27% to 14%. 8 case series studies reported 27.9% mortality for covid +ve pts. The weighted mean of hospital length stay for covid +ve pts was 15.9 compared to 9.2 days for non covid +ve with Total WMD 5.99 days.
Conclusion: there is significant increase In 30 day mortality in covid +ve patients 4 Folds compared to non-covid patients. covid +ve patients underwent hip fracture surgery had a significant longer hospital length stay compared to non-covid patients with a weighted mean difference of 6 days , IMN usage show tendency to increased usage In studies with a higher mortality rates. ORIF associated with increased mortality rate than Arthroplasty.