Social Distancing or Socially Dividing? A Greater Proportion of Vulnerable Patients Admitted to a Metropolitan Burn Center During the COVID-19 Pandemic.

Due to stay-at-home mandates and social distancing, we hypothesized the coronavirus disease 2019 global pandemic altered the epidemiology of burn injuries that presented to a single-institution, metropolitan burn center. A retrospective review of adult and pediatric patients admitted to the center during a three-year period: 3/20/19-3/19/20 (Pre-Pandemic Year), 3/20/20-3/19/21 (Pandemic Year 1), and 3/20/21-3/19/22 (Pandemic Year 2). Variables included patient demographics, burn injury, and hospitalization characteristics. A greater proportion of males compared to females were admitted during the Pre-Pandemic Year with a significant increase in this difference during Pandemic Year 1 (p<0.05). There was a significant increase in the proportion of undomiciled patients admitted between the Pre-Pandemic Year and Pandemic Year 2 (p<0.01). There were significant increases in the proportion of admitted patients who were uninsured, had a history of mental illness and/or substance abuse between Pandemic Years 1 and 2 (p<0.001, p<0.05, p<0.01) and between the Pre-Pandemic Year and Pandemic Year 2 (p<0.001, p<0.01, p<0.001). There were significant differences in deepest burn depth and burn etiology between individual years. The proportion of burn patients treated purely non-operatively significantly increased during Pandemic Year 1 (p<0.05). Greater changes in the demographics of burn patients admitted after the onset of the pandemic were reported compared to the characteristics and management of their burn injuries. Overall, this study demonstrated that a greater proportion of vulnerable patients were admitted during the pandemic, providing a better understanding of existing health disparities and the differential impact of the pandemic on lower socioeconomic populations.