The Impact of the COVID-19 Pandemic on Burn Admissions at a Major Metropolitan Burn Center.

The impact of the coronavirus disease 2019 (COVID-19) pandemic on admission patterns and outcomes at a burn center is still largely unknown. The aim of this study was to determine how the COVID-19 pandemic affected the epidemiology of burn admissions at a major metropolitan burn center. This retrospective cohort study examined how the COVID-19 pandemic affected burn volumes and time to presentation. All burn admissions were included from January 20 to August 31 for the years 2020, 2019, and 2018. The COVID-19 pandemic group included admissions from January 20, 2020 to August 31, 2020 and was compared to the nonpandemic group comprised of admissions from January 20 to August 31 in 2018 and 2019. Subgroup analysis was performed according to meaningful dates during the COVID-19 pandemic including the first U.S. COVID-19 case, shelter-in-place, and state reopening orders. Admission volumes were 403 patients in the COVID-19 pandemic group compared to a mean of 429 patients in the nonpandemic group, which correlated to a 5.8% decrease in volume during the pandemic. The pandemic group showed an increase in time to presentation of 1 day (P < .0001). Subgroup analysis demonstrated stable admission volumes and an increase in time to presentation of 1 day (P < .0001) at each time point. During shelter-in-place orders, there were higher rates of second/third-degree burns and operative burns (94.7 vs 56.3% and 45.6 vs 27%, P < .0001, P = .013). During the pandemic, there were stable admission volumes, delayed time to admission, and an increase in operative burns during shelter-in-place orders. This reinforces the need to maintain appropriate burn center staffing and resources during the COVID-19 pandemic.

Comparisons of muscle strength, size, and voluntary activation in pre- and post-pubescent males and females.

PURPOSE: The purpose of this study was to compare measurements of muscle strength, size, and activation of the forearm flexors in pre- and post-pubescent males and females. METHODS: Forty pre-pubescent (mean ± 95% confidence interval, age = 9.79 ± 0.35 years, n = 10 males, n = 10 females) and post-pubescent (age = 17.23 ± 0.58 years, n = 10 males, n = 10 females) youth participated. Subjects completed maximal voluntary isometric contractions (MVICs) of the forearm flexors, and submaximal isometric step muscle actions at 30, 50, and 70% of the peak MVIC. Percent voluntary activation (VA) was quantified during all isometric muscle actions. Forearm flexor (biceps brachii and brachialis) muscle cross-sectional area (CSA) was quantified from ultrasound images. RESULTS: MVIC strength was expressed in absolute terms and normalized to CSA. Post-pubertal males were 130% stronger, had 101% greater CSA, and 17% greater maximal VA than pre-pubertal males, while post-pubertal females were 72% stronger, had 54% greater CSA, and 23% greater maximal VA than pre-pubertal females. When MVIC strength was normalized to CSA, the post-pubertal males were still 15% stronger than the pre-pubertal males, while the post-pubertal females were only 12% stronger than the pre-pubertal females. The responses for VA across intensity reflected differences in muscle activation strategies between pre- and post-pubertal males and females. CONCLUSION: These results suggest that muscle size may account for a greater proportion of the growth and development-related differences in strength among males, while females may be more affected by changes in muscle activation. Regardless of sex, changes in muscle size and neuromuscular function influence strength increases during growth and development.