Plastic Surgery Department and Burn Center, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.
Burns. 2022 Feb;48(1):228-233. doi: 10.1016/j.burns.2021.03.006. Epub 2021 Apr 6.
The worldwide coronavirus disease 2019 (COVID-19) epidemic, caused by the SARS-CoV-2 coronavirus, is the defining global health crisis of our time. Spain has had one of the highest burdens of COVID-19 worldwide. During this period, Vall d'Hebron University Hospital Burn Center (Barcelona) has faced a unique challenge: supporting the hospital response against COVID whilst continued offering an optimal care to the burn patient.
The aim of this study is to characterize the clinical and epidemiological characteristics of acute burn patients who received urgent health care or admission to the our Burn Center during the mandatory confinement period in Spain forced by the COVID-19 epidemic.
We analyzed the medical records of burn patients who received urgent care and/or admission to our Burn Center during the mandatory confinement period in Spain (Period 1: from March 14th to May 9th, 2020) and during the same period of the last year (Period 2: from March 14th to May 9th, 2019). Both groups were compared in order to find differences in the epidemiologic profile of burned patients.
A total of 350 burns cases were analyzed. A 36% reduction in the number of emergency department visits was identified during Period 1. However, we found an increase in the rate of hospital admissions in Period 1 (20% of the burn cases) compared with Period 2 (13% of the burn cases). Seventy-six burn-related primary admissions were analyzed: 37 patients were admitted during Period 1 and 39 patients during Period 2. No differences were found between the two periods in the proportion of patients that underwent surgical treatment: 59.5% of patients admitted during Period 1 and 61.5% of patients admitted during Period 2. A statistically significant increase was noted in the rate of paediatric (aged 0-16 years old) admissions during Period 1 (40.54%, n = 15) compared to Period 2 (20.5%, n = 8). Among paediatric patients, an increase in the rate of surgical procedures was noted in Period 1 (47% of children), compared with Period 2 (37% of children). Proportion of patients that were admitted to the Intensive Care Unit was higher among burn children admitted during period 1 (46.7%, n = 7) than those admitted during Period 2 (25%, n = 2). Among the 37 patients admitted during the lockdown period, two positive COVID-19 patients were confirmed.
This study gives an overview of the clinical and epidemiologic profile of burned patients during the stringent lockdown in Spain forced by the COVID-19 epidemic. Our data shows a stable trend in the number of burn-related admissions and burn related-surgeries during the confinement period. A significant increase in the rate of burn children admitted and an increase in the severity of injuries in this population is noted. These data must be taken in account in the development of strategies to ensure the maintenance of Burn Centers function in extremely situations such as the current epidemic. A lack of effective burn prevention campaigns in our environment has been noted and the development of focused prevention strategies is a priority.
由 SARS-CoV-2 冠状病毒引起的全球 2019 年冠状病毒病（COVID-19）大流行是我们这个时代全球健康危机的定义。西班牙是全球 COVID-19 负担最重的国家之一。在此期间，巴塞罗那 Vall d'Hebron 大学医院烧伤中心（Barcelona）面临着独特的挑战：既要支持医院应对 COVID-19，又要为烧伤患者提供最佳护理。
本研究旨在描述在西班牙 COVID-19 大流行强制禁闭期间（第 1 期：2020 年 3 月 14 日至 5 月 9 日）和去年同期（第 2 期：2019 年 3 月 14 日至 5 月 9 日）期间，因急性烧伤而接受紧急医疗或入住我们烧伤中心的烧伤患者的临床和流行病学特征。
我们分析了在西班牙 COVID-19 大流行强制禁闭期间（第 1 期：2020 年 3 月 14 日至 5 月 9 日）和去年同期（第 2 期：2019 年 3 月 14 日至 5 月 9 日）期间因急性烧伤而接受紧急护理和/或入住我们烧伤中心的烧伤患者的病历。为了发现烧伤患者流行病学特征的差异，我们对这两组患者进行了比较。
共分析了 350 例烧伤病例。第 1 期急诊就诊人数减少了 36%。然而，我们发现第 1 期住院人数增加（烧伤病例的 20%），而第 2 期住院人数（烧伤病例的 13%）。分析了 76 例烧伤相关初次入院病例：第 1 期有 37 例患者入院，第 2 期有 39 例患者入院。在接受手术治疗的患者比例方面，两期之间没有差异：第 1 期有 59.5%的患者入院，第 2 期有 61.5%的患者入院。第 1 期（40.54%，n=15）儿童入院率明显高于第 2 期（20.5%，n=8）。在儿科患者中，第 1 期（47%的儿童）手术率高于第 2 期（37%的儿童）。第 1 期（46.7%，n=7）入住 ICU 的烧伤儿童比例高于第 2 期（25%，n=2）。在封锁期间入院的 37 名患者中，有 2 名 COVID-19 阳性患者被确诊。
本研究概述了 COVID-19 大流行期间西班牙严格禁闭期间烧伤患者的临床和流行病学特征。我们的数据显示，在禁闭期间，烧伤相关入院人数和烧伤相关手术数量呈稳定趋势。烧伤儿童入院人数显著增加，该人群的伤势加重。在当前疫情等极端情况下，必须考虑到这些数据，以确保烧伤中心的功能得以维持。我们注意到，我们的环境中缺乏有效的烧伤预防活动，制定有针对性的预防策略是当务之急。
