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St Andrew’s COVID-19 surgery safety (StACS) study: The Burns Centre experience

BACKGROUND: 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 r...

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Autores principales: Smith, A.C.D., Miranda, B.H., Strong, B., Jica, R.C.I., Pinto-Lopes, R., Khan, W., Martin, N.A., El-Muttardi, N., Barnes, D., Shelley, O.P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Ltd and ISBI. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847194/
https://www.ncbi.nlm.nih.gov/pubmed/33549394
http://dx.doi.org/10.1016/j.burns.2021.01.006
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author Smith, A.C.D.
Miranda, B.H.
Strong, B.
Jica, R.C.I.
Pinto-Lopes, R.
Khan, W.
Martin, N.A.
El-Muttardi, N.
Barnes, D.
Shelley, O.P.
author_facet Smith, A.C.D.
Miranda, B.H.
Strong, B.
Jica, R.C.I.
Pinto-Lopes, R.
Khan, W.
Martin, N.A.
El-Muttardi, N.
Barnes, D.
Shelley, O.P.
author_sort Smith, A.C.D.
collection PubMed
description BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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spelling pubmed-78471942021-02-01 St Andrew’s COVID-19 surgery safety (StACS) study: The Burns Centre experience Smith, A.C.D. Miranda, B.H. Strong, B. Jica, R.C.I. Pinto-Lopes, R. Khan, W. Martin, N.A. El-Muttardi, N. Barnes, D. Shelley, O.P. Burns Article BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. Elsevier Ltd and ISBI. 2021-11 2021-01-30 /pmc/articles/PMC7847194/ /pubmed/33549394 http://dx.doi.org/10.1016/j.burns.2021.01.006 Text en © 2021 Elsevier Ltd and ISBI. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Smith, A.C.D.
Miranda, B.H.
Strong, B.
Jica, R.C.I.
Pinto-Lopes, R.
Khan, W.
Martin, N.A.
El-Muttardi, N.
Barnes, D.
Shelley, O.P.
St Andrew’s COVID-19 surgery safety (StACS) study: The Burns Centre experience
title St Andrew’s COVID-19 surgery safety (StACS) study: The Burns Centre experience
title_full St Andrew’s COVID-19 surgery safety (StACS) study: The Burns Centre experience
title_fullStr St Andrew’s COVID-19 surgery safety (StACS) study: The Burns Centre experience
title_full_unstemmed St Andrew’s COVID-19 surgery safety (StACS) study: The Burns Centre experience
title_short St Andrew’s COVID-19 surgery safety (StACS) study: The Burns Centre experience
title_sort st andrew’s covid-19 surgery safety (stacs) study: the burns centre experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847194/
https://www.ncbi.nlm.nih.gov/pubmed/33549394
http://dx.doi.org/10.1016/j.burns.2021.01.006
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