The Impact of COVID-19 on Burns: A Brazilian Study

Abstract

During the COVID-19 pandemic, some of the strategies chosen to contain the spread, such as social isolation and use of alcohol-based hand sanitizer, were suspected to increase the risk of domestic accidents, especially burns. The aim of this study was, therefore, to investigate possible differences in epidemiological trends among burned patients admitted to the main referral hospital of the State of Minas Gerais, Brazil, before and during the pandemic. Methods: All categories of new burns admitted at the Burn Unit of the João XXIII Hospital in Belo Horizonte, Minas Gerais. The study group consisted of burn patients admitted between 1 March and 31 December 2020, and the control group consisted of those admitted between 1 March and 31 December 2019. The population was analyzed descriptively, and differences between patients admitted before and during the pandemic were tested using t-test, Wilcoxon Mann–Whitney Rank Sum test, the Chi-Squared test or Fisher’s exact test, as appropriate. Results: During the study period, 914 patients were admitted at the burns unit, 535 before the pandemic (control group) and 379 during the pandemic (study group). During the pandemic, referral from other hospitals decreased, while time between injury and admission remained unchanged. TBSA% and LOS diminished, while the depth of burns, presence of inhalation injuries, and in-hospital mortality did not. In adults, the place and mechanism of injury changed during the pandemic, while in children they did not. Conclusion: Fewer patients with burns were referred for specialized burn care during the pandemic, although patients admitted for specialized burn care had smaller TBSA% and shorter LOS.

What Changes Have Occurred in the Pattern of Paediatric Burns in the Last Years with Special Attention to the COVID-19 Pandemic?

“…This may be related to the common cultural practice in Brazil of using alcohol for cleaning and the COVID-19 prevention campaigns which encouraged the use of alcohol as an antiseptic cleaning product. Contrastingly, a Brazilian Trauma Unit reported no significant changes in cause of burns in both adults and children [57]. A children's hospital in Turkey reported that 74.2% of paediatric burn admissions were for scalds but did not compare to a pre-COVID cohort to demonstrate change [58].…”

“…Several studies reported that during the COVID-19 pandemic, the proportion of burn injuries sustained at home increased and that, indeed, burns at home accounted for most burn presentations [10,57,75]. This reflected the increased amount of time, which children spent at home during the lockdown period with the closure of childcare and schools.…”