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Occupational exposure to SARS-CoV-2 in burns treatment during the COVID-19 epidemic: Specific diagnosis and treatment protocol - 30/05/20

Doi : 10.1016/j.biopha.2020.110176 
Zhifeng Huang a, c, b, Donglin Zhuang b, c, Bing Xiong a, , David Xingfei Deng d, Hanhua Li a, Wen Lai a
a Department of Burns and Wound Repair Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy Medical Sciences, Guangzhou 510080, People’s Republic of China 
b Shantou University Medical College, Shantou 515063, People’s Republic of China 
c Guangdong Cardiovascular Institut, Guangdong Provincial People’s Hospital, Guangdong Academy Medical Sciences, Guangzhou 510080, People’s Republic of China 
d Guangzhou Ardent Clinical Laboratory,Guangzhou 510530, People’s Republic of China 

Corresponding authors.

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Highlights

Review of COVID-19 diagnosis and treatment of patients hospitalized with area≥50 % burns.
An algorithm developed to protect healthcare worker from COVID-19 during treatment.
This algorithm was followed for 4 patients in February 2020.
All healthcare worker were protected according to three-tiered protective measures.

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Abstract

Epidemic prevention and control measures for the new coronavirus disease 2019 (COVID-19) has achieved significant results. As of 8 April 2020, 22,073 infection cases of COVID-19 among healthcare workers from 52 countries had been reported to WHO. COVID-19 has strong infectivity, high transmission speeds, and causes serious infection among healthcare worker. Burns are an acute-care condition, and burn treatment needs to be initiated before COVID-19 infection status can be excluded. The key step to infection prevention is to identify risk points of infection exposure, strengthen the protection against those risk points, and formulate an appropriate diagnosis and treatment protocol. Following an in-depth study of the latest literature on COVID-19 diagnosis and treatment, we reviewed the protocols surrounding hospitalization of patients with extensive burns (area≥50 %) in our hospital from February 2009 to February 2019 and, in accordance with the epidemiological characteristics of COVID-19, developed an algorithm for protection during diagnosis and treatment of burns. Therefore, the aspects of medical protection and the diagnosis and treatment of burns appear to be particularly important during the prevention and control of the COVID-19. This algorithm was followed for 4 patients who received emergency treatment in February 2020 and were hospitalized. All healthcare worker were protected according to the three-tiered protective measures, and there was no nosocomial infection. During the COVID-19 epidemic, the early stages of emergency treatment for patients with extensive burns requiring the establishment of venous access for rehydration, endotracheal intubation or tracheostomy, wound treatment, and surgery are the risk points for exposure to infection. The implementation of effective, appropriate-grade protection and formulation of practical treatment protocols can increase protection of healthcare worke and reduce the risk of COVID-19 infection exposure.

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Abbreviations : ARDS, SARS-CoV-2, COVID-19, ICTV, RT-PCR, WHO, IgM, IgG, NGS

Keywords : Burns, COVID-19, Healthcare-associated infections, Epidemic prevention and control, Exposure risk, Protection


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Vol 127

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