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. 2021 Jun;116(Pt 2):104756.
doi: 10.1016/j.chiabu.2020.104756. Epub 2020 Sep 25.

Increased proportion of physical child abuse injuries at a level I pediatric trauma center during the Covid-19 pandemic

Mark L Kovler  1 , Susan Ziegfeld  2 , Leticia M Ryan  3 , Mitchell A Goldstein  3 , Rebecca Gardner  2 , Alejandro V Garcia  2 , Isam W Nasr  2
Affiliations

Increased proportion of physical child abuse injuries at a level I pediatric trauma center during the Covid-19 pandemic

Mark L Kovler et al. Child Abuse Negl. 2021 Jun.

Abstract

Background and objectives: The Covid-19 pandemic has forced mass closures of childcare facilities and schools. While these measures are necessary to slow virus transmission, little is known regarding the secondary health consequences of social distancing. The purpose of this study is to assess the proportion of injuries secondary to physical child abuse (PCA) at a level I pediatric trauma center during the Covid-19 pandemic.

Methods: A retrospective review of patients at our center was conducted to identify injuries caused by PCA in the month following the statewide closure of childcare facilities in Maryland. The proportion of PCA patients treated during the Covid-19 era were compared to the corresponding period in the preceding two years by Fisher's exact test. Demographics, injury profiles, and outcomes were described for each period.

Results: Eight patients with PCA injuries were treated during the Covid-19 period (13 % of total trauma patients), compared to four in 2019 (4 %, p < 0.05) and three in 2018 (3 %, p < 0.05). The median age of patients in the Covid-19 period was 11.5 months (IQR 6.8-24.5). Most patients were black (75 %) with public health insurance (75 %). All injuries were caused by blunt trauma, resulting in scalp/face contusions (63 %), skull fractures (50 %), intracranial hemorrhage (38 %), and long bone fractures (25 %).

Conclusions: There was an increase in the proportion of traumatic injuries caused by physical child abuse at our center during the Covid-19 pandemic. Strategies to mitigate this secondary effect of social distancing should be thoughtfully implemented.

Keywords: Coronavirus; Covid-19; Nonaccidental trauma; Physical child abuse.

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Figures

Fig. 1
Fig. 1
Patient selection criteria. Patients <15 years of age who were entered into the trauma registry at our pediatric trauma center were considered for inclusion. The study period included the month following the statewide closure of childcare facilities in Maryland, and the corresponding period in the preceding two years. JHCC, Johns Hopkins Children’s Center.
See this image and copyright information in PMC

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