Supporting the Regional Network for Children with Burn Injuries in a Pediatric Referral Hospital for COVID-19

Pediatric head and neck burns increased during early COVID-19 pandemic

Objective

The purpose of this study was to describe patterns of burns to the head and neck in children during the early COVID-19 pandemic.

Study design

This cross-sectional study reviewed pediatric patients in the Burn Care Quality Platform Registry. Patients were included if they were ≤17.9 years old and had sustained burns to the head and neck. Patients were separated into the following groups: March 13 to September 13, 2019 (before COVID-19 pandemic, BC) or March 13 to September 13, 2020 (during the initial 6 months of the COVID-19 pandemic, C19). The study team collected patient-related variables, details regarding burn injury, burn severity, and hospital course. Univariate and bivariate analyses were calculated. The chi-squared test was used for categorical variables. Statistical significance was P < .05.

Results

Fifty-five children with head and neck burn injuries were included. There was a 200% increase in burns to the head and neck region in children in April 2021 compared with previous year. Burns to head and neck in White children occurred more often during C19 (P = .03). The study revealed differences in timing of presentation (time of burn injury to emergency department admission) in different racial groups during (White children [P = .05]), and after the pandemic (African American children [P = .02]).

Conclusions

There was a transient increase in burns to the head and neck region in children during the early pandemic compared with the historic cohort.

Impact of the 2020 French lockdown due to the SARS-CoV-2 pandemic on emergency consultations for pediatric burns in a regional referral hospital

INTRODUCTION

SARS-CoV-2 pandemic required the establishment of total lockdown in France from March 17 to May 11, 2020. We analyzed the impact of this lockdown on the pediatric burn population consulting in our burn unit during this period compared to data from previous years in order to analyze our model of emergency care for children burned during this unprecedented situation.

MATERIAL AND METHODS

We carried out a retrospective single-center study by reviewing files concerning emergency consultations for children burns during the total lockdown in France in 2020 (COVID group) compared to the same weeks of 2018 and 2019 (no-COVID group).

RESULTS

We find a significant decrease in the number of consultations (P=0.02) during the confinement period. In the "COVID" group, we found a significant increase in burn to the hand (P=0.03) and lower limbs (P=0.03). The other criteria evaluated did not find any difference between the groups. Assessment of a possible rebound effect within 2 weeks of total lockdown found an increased incidence of the children burn consultation, an increased number of older children and mainly male.

CONCLUSION

The decrease in the number of consultations alerts us to a potential increase in the functional sequelae of burns in these patients at risk. Longer-term follow-up will allow us to assess the consequences of this lockdown on this particularly at-risk population.

Pediatric Surgical Care During the COVID-19 Lockdown: What Has Changed and Future Perspectives for Restarting in Italy. The Point of View of the Italian Society of Pediatric Surgery

BACKGROUND

The coronavirus disease 2019 (COVID-19) time exacerbated some of the conditions already considered critical in pediatric health assistance before the pandemic. A new form of pediatric social abandonment has arisen leading to diagnostic delays in surgical disorders and a lack of support for the chronic ones. Health services were interrupted and ministerial appointments for pediatric surgical healthcare reprogramming were postponed. As a result, any determination to regulate the term "pediatric" specificity was lost. The aim is, while facing the critical issues exacerbated by the COVID-19 pandemic, to rebuild future perspectives of pediatric surgical care in Italy.

METHODS

Each Pediatric Society, including the Italian Society of Pediatric Surgery (SICP), was asked by the Italian Federation of Pediatric Associations and Scientific Societies to fill a questionnaire, including the following the main issues: evaluation of pre-pandemic criticalities, pediatric care during the pandemic and recovery, and current criticalities. The future care model of our specialty was analyzed in the second part of the questionnaire.

RESULTS

Children are seriously penalized both for surgical treatment as well as for the diagnostic component. In most centers, the pediatric surgical teams have been integrated with the adult ones and the specificity of training the pediatric operating nursing is in danger of survival. "Emotional" management of the child is not considered by the general management and the child has become again an adults patient of reduced size.

CONCLUSION

A new functional pediatric surgical model needs to be established in general hospitals, including activities for day surgery and outpatient surgery. To support the care of the fragile child, a national health plan for the pediatric surgery is required.