The changes in the number of patients admissions due to burns in Paediatric Trauma Centre in Wroclaw (Poland) in March 2020

Dear Editors,

I wanted to share the observations concerning the changes in the number of patients admissions due to burns in Paediatric Trauma Centre in Wroclaw (Poland) in March 2020.

In March 2020, due to Coronavirus disease (COVID-19) outbreak the Polish government has introduced new measures requiring people to stay at home, except for very limited purposes. The schools and nursing schools has been closed. Most of the people started to work from home. Children stayed at home with parents. The interesting observation in the number of patients admitted due to burns in Paediatric Trauma Centre in Wroclaw (Poland) in March 2020 was made. Usually, the number of cases in March was lower than in February. This year, the number of cases was higher.

To confirm that the differences are not just subjective observation I decided to analyse the number of patients’ admissions due to burns in Paediatric Trauma Centre in Wroclaw (Poland) in first quarter of the year in the last 5 years. The total of 1521 cases of patients admitted to in Paediatric Trauma Centre in Wroclaw (Poland) between January and March in the years 2016–2020 was included to the analysis. The statistical analysis performed with use Excel. The level of significance was p < 0.05.

The cases (1521) were divided into three groups: patients admitted due to burns, fractures and head injuries. Over the years 2016–2019 the following trends were observed: from January to March each year the number of children hospitalized due to burn was decreasing, while the number of children hospitalized due to bone fractures was increasing. No significant differences in the number of cases hospitalized due to head injuries were observed. In contrast, the number of burnt children hospitalized in our centre in March 2020 was almost 3 times higher than in February 2020. The number of children hospitalized due to bone fractures was lower in March 2020 than in February 2020. Over the years 2016–2019 the percentage of patients hospitalized due to burns in our centre never exceeded 5% of all patients admitted due to trauma. In 2020, 1528% of patients hospitalized due to trauma in the centre had burns (Table 1 ).

Table 1.

Number of cases in January, February and March in years 2016–2020 and the reason of hospitalisation.

Reason of hospitalisation		Burns		Fractures		Head injuries
Month		n	%	n	%	n	%	Total	p-Value
January	2020	5	5,26%	48	50,53%	42	44,21%	95	0.418324
	2019	7	7,78%	45	50,00%	38	42,22%	90
	2018	7	7,69%	27	29,67%	57	62,64%	91
	2017	9	7,44%	42	34,71%	70	57,85%	121
	2016	7	6,25%	41	36,61%	64	57,14%	112
February	2020	3	3,23%	46	49,46%	44	47,31%	93	0.528871
	2019	6	5,88%	49	48,04%	47	46,08%	102
	2018	5	5,00%	40	40,00%	55	55,00%	100
	2017	7	7,37%	42	44,21%	46	48,42%	95
	2016	6	6,52%	32	34,78%	54	58,70%	92
March	2020	11	1528%	34	47,22%	27	37,50%	72	0.020389
	2019	4	3,88%	55	53,40%	44	42,72%	103
	2018	4	3,70%	48	44,44%	56	51,85%	108
	2017	7	5,00%	66	47,14%	67	47,86%	140
	2016	4	3,74%	47	43,93%	56	52,34%	107

To confirm if the differences are statistically significant the statistical analysis of the cases hospitalized in Paediatric Trauma Centre in Wroclaw between January and March in the years 2016–2020 was performed. There were no statistically significant results when compared the cases hospitalized over 2016–2020 in January (p = 0.42) and February (p = 0.53). However, when analysed March 2016–2020 the differences were statistically significant (p = 0.02). The trends in the number of patients admitted to hospital due to burn injuries over the years are presented in Fig. 1 .

Fig. 1.

Percentage of patients hospitalized due to burns in years 2020–2016.

One of possible explanaition of such observations can be oubreak od coronavirus disease. On December 31, 2019, Chinese health officials reported a cluster of cases of acute respiratory illness in the city of Wuhan, in central China [1]. Chinese health officials confirmed that a novel coronavirus (2019-nCoV) was associated with this initial cluster [1]. The disease was spreading in Europe. On March 4, 2020, the first case of coronavirus disease was reported in Poland (in Zielona Góra) [2]. On March 11, the classes at schools were cancelled. schools, kindergartens and nurseries were closed. The seasonal changes in the epidemiology of thermal burns is related to the fact that most of injuries in small children take place at home. It is worth noting that the incidence of burns is affected by climatic differences. In regions of the world where there is seasonal temperature variability, burns are more common in the winter months [3,4]. The surprising increase in the number of cases of paediatric burns can be related to the fact that children stayed at home with parents, who apart from looking after for them were supposed to work (“home-office”). A stay-at-home order to restrict movements of population as a mass quarantine strategy for suppressing pandemic by ordering residents to stay home except for essential tasks or going to work in essential businesses was implemented. The pandemic is difficult experience for all the population. The problems with achievement of the WHO24h movement behaviour guidelines which recommend 60 min a day of moderate-to-vigorous physical activity for 5–17 year olds were noticed [5]. Moreover, the difficulties due to social distancing among adolescents, who grow in independence [5]. So far, there are no data about the changes in the number of burn injuries due to the restrictions.

It seems, that all changes in lifestyle can affect children’s health. Staying at home can be related with increase of burn injuries, especially in the youngest population. Public health officials should increase the knowledge of parents about safety behaviours and decreasing risk of injuries during stay at home. Because hospitalisation due to burn during Covid-19 pandemic can put the child at risk of getting the infectious disease.

Conflict of interest

No conflict of interest.