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. 2021 Jun;36(3):251-259.
doi: 10.1017/S1049023X21000285. Epub 2021 Mar 1.

COVID-19 Changed the Injury Patterns of Hospitalized Patients

Michael Rozenfeld  1 , Kobi Peleg  1   2 , Adi Givon  1 , Miklosh Bala  3 , Gad Shaked  4 , Hany Bahouth  5 , Moran Bodas  1   2
Affiliations

COVID-19 Changed the Injury Patterns of Hospitalized Patients

Michael Rozenfeld et al. Prehosp Disaster Med. 2021 Jun.

Abstract

Introduction: Injury patterns are closely related to changes in behavior. Pandemics and measures undertaken against them may cause changes in behavior; therefore, changes in injury patterns during the coronavirus disease 2019 (COVID-19) outbreak can be expected when compared to the parallel period in previous years.

Study objective: The aim of this study was to compare injury-related hospitalization patterns during the overall national lockdown period with parallel periods of previous years.

Methods: A retrospective study was completed of all patients hospitalized from March 15 through April 30, for years 2016-2020. Data were obtained from 21 hospitals included in the national trauma registry during the study years. Clinical, demographic, and circumstantial parameters were compared amongst the years of the study.

Results: The overall volume of injured patients significantly decreased during the lockdown period of the COVID-19 outbreak, with the greatest decrease registered for road traffic collisions (RTCs). Patients' sex and ethnic compositions did not change, but a smaller proportion of children were hospitalized during the outbreak. Many more injuries were sustained at home during the outbreak, with proportions of injuries in all other localities significantly decreased. Injuries sustained during the COVID-19 outbreak were more severe, specifically due to an increase in severe injuries in RTCs and falls. The proportion of intensive care unit (ICU) hospitalizations did not change, however more surgeries were performed; patients stayed less days in hospital.

Conclusions: The lockdown period of the COVID-19 outbreak led to a significant decrease in number of patients hospitalized due to trauma as compared to parallel periods of previous years. Nevertheless, trauma remains a major health care concern even during periods of high-impact disease outbreaks, in particular due to increased proportion of severe injuries and surgeries.

Keywords: COVID-19; injury patterns; injury severity; lockdown; surgery.

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Figures

Figure 1.
Figure 1.
(A) Trends of Hospitalizations due to Trauma Injuries According to Injury Mechanism; (B) Trends of Proportion of Each Injury Mechanism Out of All Trauma Patients (March 15-April 30 of every studied year). Note: Presented differences of year 2020 compared to previous years are significant (Chi-Square sig.<.05). Abbreviation: RTC, road traffic collision.
Figure 2.
Figure 2.
Injury Severity Trends According to Injury Mechanisms (Proportion of ISS 16+ in the Period of March 15-April 30 of Every Studied Year). Note: Presented differences of year 2020 compared to previous years are significant (Chi-Square sig.<.05). Abbreviations: ISS, Injury Severity Score; RTC, road traffic collision.
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