Written on April 08, 2020
As communities worldwide practice social distancing to slow the spread of COVID-19 (coronavirus), many burn survivors are wondering if they are at a greater risk. We connected with Dr. Victor Joe, a burn surgeon and Phoenix board member, to learn more.
According to Dr. Joe, there is a growing need to understand how a burn injury affects long-term health. There’s still a lot we don’t know about how burns impact the development of chronic disease—and there’s a lot we don’t know about coronavirus.
All individuals are at risk for COVID-19. Because the virus is new, no one has immunity.
There is no information to suggest COVID-19 infection can occur via open skin wounds. Infection doesn’t occur via exposure to skin itself, but through contact with mucosal surfaces like eyes, nose, and mouth. (This is why it’s important to avoid touching your face as much as possible.)
People with previous burn injuries may be at higher risk of cardiovascular diseases, diabetes, and respiratory infections. Dr. Joe cites the need for broader population-based studies to validate these findings.
The Center for Disease Control (CDC) lists the following groups as high-risk for severe illness of COVID-19:
People 65 years and older
People who live in a nursing home or long-term care facility
People of all ages with underlying medical conditions, particularly if not well controlled, including:
People with chronic lung disease or moderate to severe asthma
Past prolonged need for mechanical ventilation for inhalation injury and respiratory failure may lead to chronic lung disease.
Chronic lung disease should be diagnosed by a physician, but here are some symptoms that may indicate diminished lung function and/or a chronic lung disease:
Shortness of breath with mild activity (e.g., climbing a flight of stairs)
Wheezing (noisy, high-pitched, and/or coarse sound when breathing, especially when exhaling)
Chronic cough
Frequent respiratory infections such as cold and flu
People who have serious heart conditions
People who are immunocompromised
Many conditions can cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications
People with severe obesity (body mass index [BMI] of 40 or higher)
People with diabetes
People with chronic kidney disease undergoing dialysis
People with liver disease
Based on what we know now, Dr. Joe believes burn survivors, especially those who survived major burn injuries, are at higher risk for development of severe disease to the extent they have the risk factors listed above.
“For me, the factor that is most unclear in terms of burn injury and COVID-19 is that of immune compromise,” says Dr. Joe. “I do not think we understand the extent and/or persistence of immune suppression burn survivors have and its potential relationship to burn size.”
With more questions than answers, it can be hard to know how to stay safe. Here’s what Dr. Joe recommends:
Strict adherence to social distancing and hand hygiene
Follow CDC guidance on masking
Monitor closely for symptoms: fever, cough, shortness of breath
Seek medical attention if you have:
Trouble breathing
Persistent chest pain/pressure
A fever of 100.4 degrees or above
New onset of lethargy or confusion
Blue color of lips or face (The latter two are signs of low amount of oxygen in the blood.)
To learn more about protecting yourself and others from COVID-19, check out the CDC's guidelines.