St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK.
St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK.
Burns. 2021 Nov;47(7):1547-1555. doi: 10.1016/j.burns.2021.01.006. Epub 2021 Jan 30.
The COVID-19 pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has the potential to significantly impact burns patients both directly through infective complications of an immunocompromised cohort, and indirectly through disruption of care pathways and resource limitations. The pandemic presents new challenges that must be overcome to maintain patient safety; in particular, the potential increased risks of surgical intervention, anaesthesia and ventilation. This study comprehensively reviews the measures implemented to adapt referral pathways and mitigate the risk posed by COVID-19 during the height of the pandemic, within a large Burns Centre.
A prospective cohort study was designed to assess patients treated at the Burns Centre during the UK COVID-19 pandemic peak (April-May 2020), following implementation of new safety measures. All patients were analysed for 30-day mortality. In addition, a prospective controlled cohort study was undertaken on all inpatients and a random sample of outpatients with telephone follow-up at 30 days. These patients were divided into three groups (operative inpatients, non-operative inpatients, outpatients). COVID-19 related data collected included test results, contact with proven cases, isolation status and symptoms. The implemented departmental service COVID-19 safety adaptations are described.
Of 323 patients treated at the Burns Centre during the study period, no 30-day COVID-19 related deaths occurred (0/323). Of the 80 patients analysed in the prospective controlled cohort section of the study, 51 underwent COVID-19 testing, 3.9% (2/51) were positive. Both cases were in the operative group, however in comparison to the non-operative and outpatient groups, there was no significant increase in COVID-19 incidence in operative patients.
We found no COVID-19 related mortality during the study period. With appropriate precautions, burns patients were not exposed to an increased COVID-19 risk. Similarly, burns patients undergoing operative management were not at a significantly increased risk of contracting COVID-19 in comparison to non-operative groups.
由严重急性呼吸系统综合症冠状病毒 2（SARS-CoV-2）引起的 COVID-19 大流行有可能直接通过免疫受损人群的感染性并发症，以及通过破坏护理途径和资源限制来对烧伤患者产生重大影响。这场大流行带来了新的挑战，必须克服这些挑战以确保患者安全；特别是手术干预、麻醉和通气的潜在风险增加。本研究全面回顾了在英国 COVID-19 大流行高峰期（2020 年 4 月至 5 月）期间，在一家大型烧伤中心内实施的适应转介途径和减轻 COVID-19 风险的措施。
设计了一项前瞻性队列研究，以评估在英国 COVID-19 大流行高峰期（2020 年 4 月至 5 月）期间在烧伤中心接受治疗的患者，在实施新的安全措施后。对所有患者进行 30 天死亡率分析。此外，对所有住院患者和随机抽取的门诊患者进行前瞻性对照队列研究，并在 30 天进行电话随访。这些患者分为三组（手术住院患者、非手术住院患者、门诊患者）。收集的 COVID-19 相关数据包括检测结果、与确诊病例的接触情况、隔离状态和症状。描述了部门服务 COVID-19 安全适应措施的实施情况。
在研究期间，323 名在烧伤中心接受治疗的患者中没有发生与 COVID-19 相关的 30 天死亡（0/323）。在研究的前瞻性对照队列部分分析的 80 名患者中，51 名接受了 COVID-19 检测，3.9%（2/51）检测结果呈阳性。这两个病例均在手术组，但与非手术组和门诊组相比，手术患者 COVID-19 的发病率并没有显著增加。
在研究期间，我们没有发现与 COVID-19 相关的死亡。通过适当的预防措施，烧伤患者没有面临增加的 COVID-19 风险。同样，与非手术组相比，接受手术治疗的烧伤患者感染 COVID-19 的风险没有显著增加。
