The Effect of the 2020 COVID-19 Pandemic Lockdown on Hand Injury Patient Numbers and Profiles at Charlotte Maxeke Johannesburg Academic Hospital: A Retrospective Study from 2019 to 2021

Abstract

The COVID-19 outbreak, first identified in December 2019 in China, was declared a pandemic by the WHO on March 11th, 2020. On March 23rd, a nationwide lockdown was announced in an attempt to reduce infection rates. This involved, but was not limited to, restrictions on people’s movement and prohibition on the sale of intoxicants. Hand injuries account for one-third of all traumatic injuries managed at hospitals. Resulting in severe morbidity, loss of employment, significant cost to the State, and subsequent detrimental effects on the economy. The purpose of this study is to determine the effect of the COVID-19 Pandemic March – May lockdown period in 2020 on hand injury cases presenting to CMJAH (a central academic hospital in Johannesburg) by comparing the two months during the 2020 lockdown and the same time in 2019 and 2021. This is a retrospective epidemiological study at CMJAH of hand injury numbers and patient profiles during the study period. Data was collected from adult patients presenting to CMJAH for hand injuries during the inclusion period between March 27th to May 31st, 2020 compared to data from the same period in 2019 and 2021. Data collection was from patient files, ED ledger, theatre records, treatment, and hospital stay. Demographics 6 included sex, age, dominant and injured hand, type of injury, mechanism of injury, and management. A total of 541 patients with hand injuries were included in the study. A reduction in hand trauma admissions and consultations due to lockdown restrictions was found. 44.55% presented in 2019, 24.4% in 2020 and 31.05% in 2021. Among the patients in the study, 77.08% of cases were male. Most of the patients were right-hand dominant and were injured to the right hand. In this study injuries were more frequent between the ages of 25 and 35, the average age of patients was 33 years. The most common mechanism of injury encountered in all three time intervals did not change. They were penetrating injury, blunt injury, and infection. Most patients sustained injuries were classified as minor in severity. This study described the epidemiology of hand injuries based on the patients presenting to the ED at CMJAH during the lockdown. It elucidated the changes in the profile of cases, reflected in the significant decrease in attendance.