Impact of COVID-19 on Patient Trends and Outcome: Results from a Tertiary Care Burn and Plastic Unit in Northern India

Abstract

Background Burn and trauma injuries need emergency care and resuscitation, which required uninterrupted delivery of inpatient care services during the coronavirus disease 2019 (COVID-19) pandemic. Burn patients are physiologically immunocompromised, increasing the risk of COVID-19 infection in them. This study analyzes the impact of COVID-19 pandemic on patient trends in a burn and plastic unit and assesses the effect of COVID-19 infection in burns. Methods This single-center, retrospective observational case–control study was conducted in the Department of Burns, Plastic and Maxillofacial Surgery of a tertiary care hospital in New Delhi, India. Patient data was collected from April 1, 2019 to August 10, 2019 and from April 1, 2020 to August 10, 2020. All data of burns and trauma patients collected was analyzed and compared. Results There were total 350 admissions during COVID time period and 562 admissions during non-COVID time period. The admission rate, type of burn injury, and death rate did not vary significantly during the two time periods. Thermal burn was the most common type of burn injury. There were total 18 cases diagnosed to be COVID-19 positive during the pandemic. There were two deaths among COVID-19 positive burn cases. Conclusion This study finds no difference in patient patterns during COVID and non-COVID time period. Amongst burn patients, no increased risk of COVID-19 infection is seen with larger body surface area of burns. No increase in mortality is seen in burn patients infected with COVID-19.

The effect of COVID‐19 pandemic on the number of patients in burns services

“… 7 In another study conducted in India, a decrease of 37.7% was observed. 8 When we analysed burn patients by gender during the pandemic process, no significant change was found, similar to the findings of other studies. 5 , 9 …”

“…7 In another study conducted in India, a decrease of 37.7% was observed. 8 When we analysed burn patients by gender during the pandemic process, no significant change was found, similar to the findings of other studies. 5,9 When the effects of COVID-19 were examined by age groups in our study, the age range of 19 to 59 years was the most affected group in both periods and was not affected by the COVID-19 pandemic.…”

“…In addition, Chu et al found a 28% decrease in the admission of burn patients after the COVID‐19 pandemic started 7 . In another study conducted in India, a decrease of 37.7% was observed 8 . When we analysed burn patients by gender during the pandemic process, no significant change was found, similar to the findings of other studies 5,9 …”

The effect of COVID-19 on burn management and outcomes in a resource-limited setting

“…In contrast to our study, data from a tertiary center in New Delhi, India, showed a decrease in admissions to their center but without a change in patient outcomes. [18] Data from HICs such as the United Kingdom and the United States have shown variations in admission patterns but relatively little change in access to operative intervention or patient outcomes. [19] , [20] The heterogeneity of published reports suggests that regional pandemic factors had a significant effect on burn patient epidemiology and that some burn centers were more prepared than others to address changes in supplies, staffing, or operating room access.…”

Sustained high demand for intensive care unit resources for the treatment of burn patients during the COVID-19 pandemic in Northern Germany: A single-centre cross-sectional study

“…Similar results were reported in the literature [16] . During the COVID-19 pandemic, a new mechanism of burn sustained by the usage of hand sanitiser followed by thermal exposition by cooking or lighting of a cigarette was reported, as patients were not aware of the flammable composition of hand sanitiser [17] . However, in our study population, this new mechanism was not found to cause burn injuries.…”