Timeout? The Epidemiology of Pediatric Sports Injuries During the COVID-19 Pandemic

Abstract

Background: The COVID-19 pandemic resulted in closure of schools and playgrounds while requiring social distancing, changes that likely affected youth sports participation. The purpose of this study was to identify changes in the epidemiology of pediatric sports injuries during the COVID-19 pandemic. Methods: This retrospective cohort study included patients between the ages of 4 and 18 years who presented to orthopaedic clinics within a single children's hospital network with an acute injury sustained during athletic activity between March 20, 2020, and June 3, 2020 (the strictest period of state-level shelter-in-place orders). These patients were compared with those within the same dates in 2018 and 2019. Chi square and Mann-Whitney U tests were used, as appropriate. Results: Significantly less sports injuries were seen during the pandemic (n = 257) compared with the same dates in 2018 (n = 483) and 2019 (n = 444) despite more providers available in 2020 (P , 0.001). During the pandemic, patients with sports injuries were younger (median age 11 versus 13 years, P , 0.001) and had less delay in presentation (median 5 versus 11 days, P , 0.001). A higher proportion were White (66.9% versus 47.7%, P , 0.001), privately insured (63.4% versus 48.3%, P , 0.001), and seen at a nonurban location (63.4% versus 50.2%, P , 0.001). Most sports injuries during the pandemic were fractures (83.7%). Although 71.4% of all injuries in the prepandemic period occurred in the context of formal sports, only 15.2% were sustained in a formal athletic context in 2020 (P , 0.001). The frequency of surgical treatment was higher during the pandemic (14.8% versus 7.8%, P = 0.001), mainly because most of these injuries were fractures requiring surgical intervention. Conclusions: Fewer sports injuries were seen in the outpatient setting during the COVID-19 pandemic, and most of these injuries were fractures and occurred outside of organized sports settings. Patients were more likely to be White, privately insured, and seen at a nonurban location.

Effect of the COVID-19 Pandemic on Injuries Related to Individual and Team Sports: An Analysis of the NEISS Database Between 2017 and 2021

“…Significant trends found in our study included the decrease in relative frequency of sprains/strains and the increase in relative fracture frequency in both 2020 and 2021. A study by Wild et al 31 also revealed a higher proportion of orthopaedic sports injuries to be fractures in 2020. Baxter et al 4 found a 108.4% increase in proportion of supracondylar fractures presenting to clinic during lockdown when compared with 2019.…”

“…Several studies have investigated the change in pediatric emergency room and outpatient visits for trauma, sport, and non–sport related injuries due to the COVID-19 pandemic. 22,24,31 Pines et al 22 found that there was a 67% decrease in non–COVID-19 emergency room visits from March to April 2020 for individuals 14 to 17 years of age compared with the same time period in 2019. 22 A study investigating outpatient orthopaedic clinics from a single children’s hospital network revealed that 15.2% of the injuries treated from March to June 2020 were sustained in a formal sports setting, compared with 71.4% in 2018 and 2019.…”

“…22 A study investigating outpatient orthopaedic clinics from a single children’s hospital network revealed that 15.2% of the injuries treated from March to June 2020 were sustained in a formal sports setting, compared with 71.4% in 2018 and 2019. 31 The development of vaccines in 2021 led to hopes that sports participation would normalize. During this year, there was a wide variety in the easing of COVID-19–related restrictions.…”

Changes in sport-related concussion and traumatic brain injury in New Zealand during the first two years of the COVID-19 pandemic

“…The reduction in sport-related concussion and TBI claims in New Zealand during the COVID-19 pandemic is consistent with observed decreases in the incidence of sport-related injuries in other countries. 15 , 16 , 17 For instance, studies have demonstrated that lockdowns and restrictions related to the COVID-19 pandemic resulted in significant declines in sport-related injuries presenting to Emergency Departments and level 1 paediatric trauma hospitals in the United States. 15 , 16 There were also fewer sport-related injuries seen in outpatient settings during the COVID-19 pandemic, and most of these injuries occurred outside of organised sports settings.…”

“… 15 , 16 There were also fewer sport-related injuries seen in outpatient settings during the COVID-19 pandemic, and most of these injuries occurred outside of organised sports settings. 17 Naturally, the magnitude of the reduction in incidence varies depending on the level and duration of government-imposed restrictions across countries and regions. In New Zealand, alert level 3 or 4 was imposed for 14 % and 6 % of 2020 and 2021, respectively, whilst the estimated reductions in sport-related concussion and TBI claims were 30 % and 10 % for 2020 and 2021, respectively.…”