Chlorine poisoning caused by improper mixing of household disinfectants during the COVID-19 pandemic (preprint)

ABSTRACT

Background: During the coronavirus disease 2019 (COVID-19) pandemic, many people have abused and misused disinfectants, leading to many poisoning incidents. However, there are few clinical case reports of poisoning caused by mixed household disinfectants. This study summarized the clinical characteristics and treatment effects of chlorine poisoning caused by improper mixing of hypochlorite bleach with acidic cleaning agents to improve the understanding of the disease. Methods We retrospectively analyzed the basic data, clinical symptoms, treatment methods, imaging, and other clinical data of seven patients with chlorine poisoning, caused by an improper mixture of hypochlorite bleach and acidic cleaning agents, who were admitted to the National Army Poisoning Treatment Center. Results The seven patients (three men and four women) had an average age of 48.8 years (18–67 years). The average poisoning time (time from exposure to poison to treatment) was 57 h (4–240 h). All seven patients were involved in cleaning bathrooms during the COVID-19 pandemic. Chest computed tomography scans showed bilateral lung effusions or inflammatory changes in five patients and no obvious exudation or inflammatory changes in two. The partial pressure of oxygen decreased in six patients, and respiratory failure occurred in one. Five patients had different degrees of increase in white blood cell count. For treatment, humidified oxygen therapy, non-invasive mechanical ventilation, intravenous corticosteroids, inhaled hormone, bronchial spasmolytics, antibiotics, and other symptomatic and supportive treatments were provided. The average length of hospital stay was 7 days (4–9 days). All seven patients recovered and were discharged. Conclusions Improper mixing of house disinfectants during the COVID-19 pandemic may cause damage to the respiratory system due to chlorine poisoning. Corticosteroids may improve lung exudation in severe cases. Additionally, symptomatic supportive treatment should be performed early.