61 A Burn Center’s Experience with COVID-19 Positive Burn Patients

Introduction

The emergence of SARS-COV-2 and the COVID-19 pandemic has complicated the presentation, treatment, and prognosis of all types of patients. Further characterization and analysis of how concomitant COVID-19 infection impacts different patient populations is important for improving treatment strategies. Patients with burn injures often require ICU-level care, mechanical ventilation, and extensive surgical intervention. Concomitant COVID-19 infection in this population presents a new challenge to clinical teams. The purpose of this project is to compare COVID-19 positive burn patients treated at a regional burn center with those that are not.

Methods

Following IRB approval, our institution’s burn registry was queried from March 2020-June 2021. Data on demographics, injury circumstances, COVID-19 status, and outcomes were collected. Continuous variables were nonparametric and\compared using Mann-Whitney U test. Categorical variables were compared using Chi-squared with Fischer’s Exact test, where appropriate.

Results

Of the 622 patients admitted at our institution, 19 tested positive for COVID-19 during their hospitalization. Demographic and injury information is reported in Table 1. There were statistically significant differences between the COVID-19 positive and negative groups in regard to race and presence of inhalation injury (p=0.0002, p=0.0002). The TBSA burned was slightly higher in the COVID-19 positive group (9.1 vs 6.7%). COVID-19 positive patients spent more time ventilated (48±32.5 vs.12.2 ± 16.2 days, p=0.0035**) and had both longer ICU (42.71±37.41 vs 11.1±15.4 days, p=0.0175*) and hospital (26.32±32.14 vs 8.177±11.95 days, p< 0.0001***) lengths of stay (LOS). No COVID-19 positive patients died while 5% of the COVID-19 negative patients did. All outcomes were statistically significant.

Conclusions

Despite similar TBSA injury burden and age breakdown, patients at our institution who tested positive for COVID-19 required more time on the ventilator and were hospitalized longer. People of color had a higher percentage of positive tests than their Caucasian counterparts. While mortality rates were higher in the COVID-19 negative cohort, morbidities associated with longer LOS must be considered.

752 Baking Bread and Other New Hobbies: Characterizing Burn Center Admissions During the COVID-19 Pandemic

Introduction

The effects of the ongoing COVID19 pandemic are wide-reaching and still emerging. Fear of the virus, public health messaging, and government-instituted lockdowns have altered how Americans live, work, and use the healthcare system. There is minimal data that assesses how the COVID-19 pandemic and associated stay at home orders have influenced the etiology of burn injuries. With the majority of burns occurring in the home, it is possible lock down orders have significantly impacted etiology of major burn injuries. This project aims to characterize the demographics and injury characteristics of burn patients seen at a regional burn center during the COVID-19 pandemic.

Methods

Following IRB approval, our institution queried it’s burn registry from March 2020-June 2021. Data on demographics, injury circumstance and details, interventions, COVID-19 status, and outcomes were collected. Descriptive statistics were obtained for the population.

Results

There were 622 inpatient admissions during the study timeframe. Patients were primarily Black (44.4%) or Caucasian (32.6%) males (65.6%) identifying as Non-Hispanic (81.8%). The mean age was 46.73±18.6 years. Mean total TBSA burned was 6.7±10.7%, 2nd and 3rd degree percentages were 2.11±4.64 and 0.62±5.2 respectively with 47 total inhalation injuries. Top burn etiologies were 244 (39.2%) scald and 175 (28.1%) flame with 249 (40%) coded etiology associated with food prep or consumption.

The majority of the burns occurred at home (93%). Time from injury to admission was 616.98±2199.42 minutes and time to first excision from admission was 4314.3 ± 5657.3 minutes. ICU and hospital length of stay were 12.7±18.3 and 8.73±13.3 days. In-hospital mortality was 31 (5%). Nineteen patients tested positive for COVID-19 during this time.

Conclusions

Nearly half of all burn center admissions were for cooking related etiologies during this time. Time to admission was over 10 hours in a population dense area. More information of site specific pre-pandemic etiology and treatment data are needed to fully understand these initial findings. Further sub-analyses may also elucidate the influence of pandemic related behavioral changes as public health mandates evolved over time.