Characteristics of burn injury during COVID-19 pandemic in Tokyo: A descriptive study.

The impact of COVID-19 on burn referrals received via telemedicine.

Abstract The COVID-19 pandemic has forced many Americans to adapt their daily routines. In 2020, there was a significant increase in house fires according to the National Fire Prevention Association (NFPA). The objective of this study was to characterize the changes in suspected smoke inhalations during the first year of the pandemic in the National Emergency Medical Services Information System (NEMSIS). The NEMSIS database was queried for all EMS transports captured between 2017-2020. Differences in the incidences of suspected smoke inhalations and fire dispatches in 2020 were estimated using Poisson regression models. There was a 13.4% increase in the incidence of fire dispatches and a 15% increase in suspected smoke inhalations transported in 2020 compared to the previous 3 years. The IRR of both fire dispatches (1.271; 95% CI: 1.254-1.288; p<0.001) and suspected smoke inhalation (1.152; 95% CI: 1.070-1.241; p<0.001) was significantly elevated in 2020. The increases in fire dispatches and suspected smoke inhalations observed in the NEMSIS database are in concordance with other literature indicating the increase in fire incidence and morbidity observed during the pandemic. These results should inform fire prevention outreach efforts and resource allocation in burn centers in the event of future pandemic.

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Increased Incidence Of Inhalation Burn Injury During The Covid-19 Pandemic: A National Database Study

Abstract Due to COVID-19, hospitals underwent drastic changes to operating room policy to mitigate the spread of the disease. Given these unprecedented measures, we aimed to look at the changes in operative volume and metrics of the burn surgery service at our institution. A retrospective review was conducted for operative cases and metrics for the months of March to May for 2019, 2020, and 2021, which correspond with pre-COVID, early COVID (period without elective cases), and late COVID (period with resumed elective cases). Inclusion criteria were cases related to burns. Case types and operative metrics were compared amongst the three time periods. Compared to the hospital, the burn service had a smaller decrease in volume during early COVID (28.7% vs. 50.1%) and exceeded pre-pandemic volumes during late COVID (+21.8% vs. -4.6%). There was a significant increase in excision and grafting cases in early and late COVID periods (p < .0001 and p < .002). There was a significant decrease in laser scar procedures that persisted even during late COVID (p < .0001). The projected and actual lengths of cases significantly increased and persisted into late COVID (p < .01). COVID-19 related operating room closures led to an expected decrease in the number of operative cases. However, there was no significant decline in the number of burn specific cases. The elective cases were largely replaced with excision and grafting cases and this shift has persisted even after elective cases have resumed. This change is also reflected in increased operative times.

https://academic.oup.com/jbcr/advance-article-pdf/doi/10.1093/jbcr/irac111/45290755/irac111.pdf

Changes in Burn Surgery Operative Volume and Metrics due to COVID-19

https://doi.org/10.1016/j.burns.2022.06.012

Impact of COVID-19 pandemic on the care of severe burns in Japan: Repeated survey of specialized burn care facilities

The impact of the coronavirus disease 2019 (COVID-19) pandemic on admission patterns and outcomes at a burn center is still largely unknown. The aim of this study was to determine how the COVID-19 pandemic affected the epidemiology of burn admissions at a major metropolitan burn center. This retrospective cohort study examined how the COVID-19 pandemic affected burn volumes and time to presentation. All burn admissions were included from January 20 to August 31 for the years 2020, 2019, and 2018. The COVID-19 pandemic group included admissions from January 20, 2020 to August 31, 2020 and was compared to the nonpandemic group comprised of admissions from January 20 to August 31 in 2018 and 2019. Subgroup analysis was performed according to meaningful dates during the COVID-19 pandemic including the first U.S. COVID-19 case, shelter-in-place, and state reopening orders. Admission volumes were 403 patients in the COVID-19 pandemic group compared to a mean of 429 patients in the nonpandemic group, which correlated to a 5.8% decrease in volume during the pandemic. The pandemic group showed an increase in time to presentation of 1 day (P < .0001). Subgroup analysis demonstrated stable admission volumes and an increase in time to presentation of 1 day (P < .0001) at each time point. During shelter-in-place orders, there were higher rates of second/third-degree burns and operative burns (94.7 vs 56.3% and 45.6 vs 27%, P < .0001, P = .013). During the pandemic, there were stable admission volumes, delayed time to admission, and an increase in operative burns during shelter-in-place orders. This reinforces the need to maintain appropriate burn center staffing and resources during the COVID-19 pandemic.

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Carey K Lamphier

Papers

The Impact of the COVID-19 Pandemic on Burn Admissions at a Major Metropolitan Burn Center.