Trends in the Causes and Severity of Household Burns during the COVID-19 Pandemic: A Longitudinal Study

Abstract

Background: Burn injuries remain a global public health challenge with significant morbidity, mortality, and socioeconomic burden. The COVID-19 pandemic, through nationwide lockdowns and lifestyle alterations, influenced patterns of domestic accidents, including burns. While earlier studies examined short-term effects of lockdowns, limited literature exists on longitudinal outcomes in a metropolitan burn centre.

Objective: To assess the impact of the COVID-19 pandemic on burn epidemiology, clinical severity, and outcomes, and to compare findings across pre-COVID, COVID, and post-COVID periods

Methods: A retrospective observational study was conducted at a major burn centre in Bengaluru from September 2018 to December 2022. The study period was divided into three 17-month intervals: pre-COVID (Sept 2018–Jan 2020), COVID (Feb 2020–Jun 2021), and post-COVID (Jul 2021–Dec 2022). Demographic data, type and etiology of burns, severity (total body surface area, TBSA), management, hospital stay, COVID-19 positivity, and mortality were analysed.

Results: A 30% reduction in burn admissions occurred during the COVID period. A reversal in gender distribution was observed, with females outnumbering males. Age distribution showed reduced incidence in extremes and increased incidence among middle-aged adults. Thermal burns significantly increased, while scald, electrical, chemical, and cracker-related burns decreased. Severity of burns, measured by TBSA, increased during the pandemic. Accidental burns predominated, whereas suicidal and homicidal burns declined. Mortality rates increased substantially, particularly among COVID-positive burn patients who also experienced longer hospital stays. Elective burn surgeries decreased during the pandemic due to restricted healthcare capacity.

Conclusion: The COVID-19 pandemic significantly altered the epidemiology of burns in metropolitan India. Fewer admissions masked higher burn severity and mortality, underscoring gaps in access to timely burn care. Preventive measures, community education, and resilient burn management protocols are critical for safeguarding vulnerable populations during future crises.