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?:abstract
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Objective: To introduce Treatment experience of burn patients combined with inhalation injury during epidemic period of Corona Virus Disease 2019 (COVID-19). Methods: Six burn patients combined with inhalation injury were hospitalized in Department of Burns of Tongren Hospital of Wuhan University& Wuhan Third Hospital from February 1 to March 1 in 2020duringhigh-incidence period of COVID-19, including 4 males and 2 females, aged 21-63 years, hospitalized for 2-4 hours, with total burn areas of 1%-20% TBSA and full-thickness burn areas of 1%-12% TBSA. Among them, 1 case was severe inhalation injury, 2 cases were mild inhalation injury, and 3 cases were moderate inhalation injury. The body temperatures of the patients were normal at admission without fever or cough in the past 2 weeks. At admission, chest CT of one patient showed double lower lobes and left upper lobes had multiple slices and slightly high-density shadow of nodules. Chest CT of two patients showed bilateral lung texture was thickening, and chest CT of other patients was normal. After admission, 6 patients were given routine treatment, the medical staffs paid attention to the protection and screened COVID-19 according to the diagnosis and treatment plan of COVID-19. On post injury day (PID) 1, 3, 6, and 9, vein blood of patients were collected for determination of white blood cell (WBC) count, neutrophil, lymphocyte absolute value. and level of procalcitonin (PCT). Nucleic acid of novel coronavirus was detected by real-time fluorescence reverse transcription polymerase chain reaction on PID 3 and 6. The temperatures of patients were recorded after admission. The results of chest CT within one week after injury and the prognosis of the patients were recorded. Measurement data distributed normally were expressed as x ± s, and measurement data distributed abnormally were expressed as M (P(25), P(75)). Results: (1) On PID1, 3, 6, and 9, WBC counts of patients were respectively (19.8±3.8)×10(9)/L, (17.2±3.4)×10(9)/L,(13.3±3.1)×10(9)/L, and (11.1±1.6)×10(9)/L, neutrophils of patients were respectively0.919±0.019,0.899±0.011, 0.855±0.034, and0.811±0.035, absolute values of lymphocytes of patients were respectively(0.65±0.18)×10(9)/L,(0.65±0.24)×10(9)/L,(0.91±0.34)×10(9)/L, and (1.23±0.42)×10(9)/L,and PCT values of patients were respectively0.49 (0.36, 1.64), 0.39 (0.26, 0.73), 0.28 (0.18, 0.33), and 0.12 (0.11, 0.20) ng/mL.The values of WBC and neutrophils of patients were higher than the normal value, showing a downward trend. The absolute values of lymphocyte of patients returned to the normal value gradually. The PCT values of patients were higher than the normal value. (2) Nucleic acid test results of novel coronavirus of 6 patients were negative on PID 3 and 6. The temperatures of patients were from 36.5 to 38.6 ℃. The typical imaging features of COVID-19 were not found in 6 patients within 1 week after injury by chest CT. After treatment for 14-32 days, 6 patients were cured and discharged. Conclusions: During the novel coronavirus, burn patients combined with inhalation injury should be treated under condition of good protection for COVID-19 among doctors and nurses. Meanwhile, virus should be actively screened to reduce the risk of COVID-19 infection among doctors and patients.
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