{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:31:49Z","timestamp":1777876309450,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T00:00:00Z","timestamp":1774656000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T00:00:00Z","timestamp":1774656000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Shoulder &amp; Elbow"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The COVID-19 pandemic has captured the attention of healthcare systems worldwide, and testing remains a mainstay of preoperative testing before all surgical procedures, including shoulder arthroplasty. Other viral illnesses, specifically influenza, while still having severe complications, are either overshadowed by testing for COVID-19 or not tested at all.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multi-institutional cohort study using the TriNetX network examined patients undergoing total or hemi shoulder arthroplasty from January 2020 to March 2024. Matched cohorts were created: one with influenza and one with COVID-19 infection, 14 days before surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 3233 and 18,209 patients were included in the influenza and COVID-19 cohorts, respectively. The matched cohorts both consisted of 3232 patients. Patients in the influenza cohort had a significantly higher risk of sepsis (95% CI [1.264, 2.528],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.001), stroke (95% CI [1.160, 5.052],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.015), readmission (95% CI [1.271, 1.860],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), anemia (95% CI [1.263, 2.088],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), transfusion (95% CI [1.022, 2.330],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.037), ED visits (95% CI [1.104, 1.314],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and inpatient hospitalization (95% CI [1.173, 1.295],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) during the perioperative period. The COVID-19 cohort had a significantly higher risk of opioid analgesics usage (95% CI [0.909, 0.973],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) in the perioperative period.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Patients with recent influenza infections prior to shoulder arthroplasty have a greater risk of medical complications, with no difference in implant-related complications compared to COVID-19, emphasizing the need for perioperative patient counseling and surgical planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17585732261435999","type":"journal-article","created":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T08:16:07Z","timestamp":1774685767000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Influenza infection has higher risk of postoperative complications than COVID-19 in shoulder arthroplasty patients"],"prefix":"10.1177","author":[{"given":"Jad J","family":"Lawand","sequence":"first","affiliation":[{"name":"UT Medical Branch Galveston"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2207-074X","authenticated-orcid":false,"given":"Umar","family":"Ghilzai","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caleb","family":"Witsken","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dion","family":"Birhiray","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah","family":"Ghali","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youssef M","family":"Khalafallah","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohan G","family":"Reddy","sequence":"additional","affiliation":[{"name":"NYU Grossman School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7815-9105","authenticated-orcid":false,"given":"Sameer R","family":"Khawaja","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adil Shahzad","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,28]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2022.07.020"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.sart.2022.02.011"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1302\/2633-1462.312.BJO-2022-0111.R1"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2022.10.034"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.sart.2023.02.002"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.22.01317"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.sart.2023.05.006"},{"key":"e_1_3_2_9_2","first-page":"121","article-title":"Effect of COVID-19 on shoulder arthroplasty at a tertiary care medical center in New York City","volume":"58","author":"Wang KC","year":"2023","unstructured":"Wang KC, Patel AV, White CA, et al. Effect of COVID-19 on shoulder arthroplasty at a tertiary care medical center in New York City. Rev Bras Ortop (Sao Paulo) 2023; 58: 121\u2013126.","journal-title":"Rev Bras Ortop (Sao Paulo)"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2024.04.007"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1117885"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.6061\/clinics\/2020\/e1923"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.20.00844"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2021.04.032"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.3310\/hta1120"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.07.031"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000006227"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000002315"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-049476"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-023-03086-8"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-22-11-683"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15458"},{"key":"e_1_3_2_23_2","unstructured":"ASA and APSF joint statement on elective surgery\/procedures and anesthesia for patients after COVID-19 infection [press release]. 02\/22\/2022."}],"container-title":["Shoulder &amp; Elbow"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17585732261435999","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17585732261435999","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17585732261435999","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:19:45Z","timestamp":1777587585000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17585732261435999"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,28]]},"references-count":22,"alternative-id":["10.1177\/17585732261435999"],"URL":"https:\/\/doi.org\/10.1177\/17585732261435999","relation":{},"ISSN":["1758-5732","1758-5740"],"issn-type":[{"value":"1758-5732","type":"print"},{"value":"1758-5740","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,28]]},"article-number":"17585732261435999"}}