Trauma Visits to a Pediatric Emergency Department During the COVID-19 Quarantine and “Stay at Home” Period

Abstract

Background Impact of social distancing on pediatric injuries is unknown. Methods We retrospectively compared injury visits to a pediatric emergency department by individuals ≤21 years during “Stay at Home” (SHO) period to the same period in 2019 (non-SHO). Demographics, types, and outcomes of injuries were noted. Results Although, there was a 35.6% reduction in trauma-related emergency department visits during SHO period (1226 vs 1904), the proportion of injury visits increased (15.5% vs 8.1%, P < .001) and mean age was lower (5.8 yrs ±4.5 vs 8.4 yrs ± 5.2, P < .001). There were significant increases in visits related to child physical abuse (CPA), firearms, and dog bites. Further, significant increases in trauma alerts ( P < .01), injury severity ( P < .01), critical care admissions ( P < .001), and deaths ( P < .01) occurred during the SHO period. Conclusions Although overall trauma-related visits decreased during SHO, the proportion of these visits and their severity increased. Trauma visits related to child physical abuse, dog bites, and firearms increased. Further studies are required to assess the long-term impact of pandemic on pediatric trauma epidemiology.

COVID-19 Pandemic Effects on the Epidemiology and Mortality of Pediatric Firearm Injuries; A Single Center Study

“…Our study brings to light multiple significant findings related to the effects of the COVID-19 pandemic on pediatric firearm injuries. Consistent with multiple previous studies [ 8 , [11] , [12] , [13] , [14] , [15] , [16] ], pediatric firearm injury rates were found to have significantly increased during the pandemic compared to the five preceding years. While most previous studies on the topic do not include information on the intent or circumstances surrounding the shootings [ 8 , 11 , 12 , 14 , 16 ], we found that the escalation in pediatric firearm injuries was driven by a significant increase in pediatric firearm assaults/homicides.…”

“…The relative decrease in unintentional pediatric firearm injuries that we discovered during the pandemic contradicts this theory, though the risks for firearm injury they point out are likely still accurate and significant. Our finding that pediatric firearm assaults/homicides significantly increased is likely still related in part to increased gun purchasing [ 8 , 11 , 13 , [23] , [24] , [25] ] and decreased youth supervision [ 8 , 14 , 16 ] associated with the COVID-19 pandemic. However, other factors such as COVID-19-induced economic crisis and subsequently increased neighborhood violence/crime rates may have played a more significant role in elevating pediatric firearm assaults/homicides.…”

“…One consistent limitation of previous studies researching the effect of the COVID-19 pandemic on pediatric firearm injuries is the limited timeframe included in the studies. Most work has included only shootings occurring in the first year of the pandemic [ 8 , 11 , [14] , [15] , [16] ], missing any potential effects of the widespread Delta and Omicron variant surges. To our knowledge, no previous studies have assessed for associations between pediatric firearm injuries and specific COVID-19 variant surges or variant-related increases in death rates.…”

“…Many do not include analysis of injury severity or hospital disposition [ 8 , [12] , [13] , [14] ]. Most studies are limited by timeframe, including only the first several months of the COVID-19 pandemic [ 8 , 11 , 13 , 15 , 16 ], lacking potential impacts of the extensive Delta and Omicron variant surges [17] . Furthermore, while all such studies discuss speculations regarding the underlying causes of increased firearm injuries during the COVID-19 pandemic, the majority do not include the intent or circumstances surrounding the shootings [ 8 , 11 , 12 , 14 , 16 ].…”

“…Most studies are limited by timeframe, including only the first several months of the COVID-19 pandemic [ 8 , 11 , 13 , 15 , 16 ], lacking potential impacts of the extensive Delta and Omicron variant surges [17] . Furthermore, while all such studies discuss speculations regarding the underlying causes of increased firearm injuries during the COVID-19 pandemic, the majority do not include the intent or circumstances surrounding the shootings [ 8 , 11 , 12 , 14 , 16 ]. Finally, no previous studies to our knowledge have described potential correlations between pediatric firearm injuries and specific surges in COVID-19 variants or associated COVID-19 death rates.…”