(658) Concerning Trends in Burn Patients With History of COVID-19 Virus

Introduction: The COVID-19 pandemic changed the landscape of critical care, and burn patients are no exception. While having COVID-19 during hospitalization can certainly impact outcomes, we questioned if patients with a history of COVID-19 infection were more susceptible to complications as it appeared they experienced more challenging ICU stays. Using the SARS-CoV-2 nucleocapsid test, we sought to evaluate the impact on our patients with greater than 20% total body surface area burns as they are already at increased risk of complications.

Methods: Patients were identified using the Institutional Burn Center registry and linked to the clinical and administrative data. All patients admitted to the burn service with TBSA 20-79% between September 2022 to July 2024 were included. Demographics, length of stay (LOS), co-morbid conditions, and mortality were evaluated.

Results: We admitted 165 patients during the study period, 41 of which had a positive nucleocapsid test. The raw data was assessed without adjusting for confounders. The average age was 42.9 years, 70% were male, average total body surface area burned was 32.5%, and average length of stay was 34.3 days. Compared to those not tested or with a negative SARS-CoV-2 nucleocapsid, patients testing positive had longer ICU stays (39.3 versus 13.6 days; p< 0.001), longer ventilator days (22.6 versus 16.0 days; p=0.43), increased incidence of deep venous thromboembolism (DVT) (19.5% versus 1.6%; p< 0.001), and increased mortality (19.5% versus 14.5%; p=0.46).

Conclusions: Severely burned patients testing positive for SARS-CoV-2 nucleocapsid demonstrated a higher incidence of DVT, longer ICU stays, and increased mortality in this already high-risk patient population. Quality and performance improvement projects focused on DVT prevention and adjustments in resuscitation practices are clearly needed.