ABSTRACT
INTRODUCTION: The impact of the COVID-19 pandemic on non-COVID-19 pathologies has been experienced worldwide. While people appropriately avoided social interactions, many also avoided essential medical care for acute and chronic conditions. This delay in seeking care has been associated with increased morbidity and mortality in several conditions, including life-threatening infections such as necrotizing fasciitis. METHODS: We retrospectively reviewed the records of patients that presented to the University of Vermont Medical Center for necrotizing fasciitis during the 1-year period following the declaration of a global pandemic on March 11, 2020. We subsequently compared this data with that of the previous 4 years. RESULTS: During the period of March 12, 2020 to March 12, 2021, there were 17 cases of newly diagnosed necrotizing fasciitis. Compared with an average per year of 8 cases over the previous 4 years, this represents a 113% percent increase in cases of necrotizing fasciitis during the study period (P = .071861). Out of the 17 cases, 4 patients died during their admission, producing a case-fatality rate of 23.5%. This represents a statistically significant increase from previous years (P = .003248), where the average case-fatality rate was 6.3%. CONCLUSION: Our study demonstrates a substantial increase in cases of necrotizing fasciitis following the onset of the coronavirus pandemic. A significant increase in the case-fatality rate was also observed. Given the growing body of literature describing the negative impact of the pandemic on non-COVID-19 morbidity and mortality, our study posits necrotizing fasciitis as one of many affected pathologies. LEVEL OF EVIDENCE: Level IV. Epidemiological.
ABSTRACT
Introduction: Following the onset of the COVID-19 pandemic, there was an abrupt and widespread shift in the social, political, and economic landscape. The purpose of this study is to analyze the pandemic?s impact on maxillofacial trauma patterns in a predominantly rural setting;the resultant implications for plastic surgery and other trauma-related departments was also considered. Methods: We reviewed records of patients that presented to the University of Vermont with facial trauma who were referred to Plastic Surgery and Otolaryngology during the period spanning from March 25th, 2020 to June 15th, 2020, the first full lockdown in Vermont. We compared this data with referrals made from 2016 to 2019 during the same period. Results: We found 41 patients who presented to UVM with operative facial fractures during the first COVID-19 lockdown period, which compared to an average of 51 over the prior years. Although this is a 20% decrease, it was not statistically significant (P?=?.285887). There were also decreases in the mean age (48 vs 40;P?=?.061333) and increases in the proportion of female patients (P?=?.0782055) compared to prior years, but once again no statistically significant change. Mechanism of injury patterns remained consistent with falls being the most common cause during these periods. Fracture types also remained consistent with nasal bone fractures being the most common. Conclusion: Our study shows no statistically significant decrease in volume, change in mechanism, or change in demographics of operative facial trauma patients during the first COVID-19 lockdown period. This was contrary to our expectations and to conventional wisdom, but it does have important implications for hospital staffing and resource allocation. In short, at least for our tertiary care institution serving a large rural population, these results highlight the importance of continued support of plastic and reconstructive surgery as well as related disciplines.