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. 2021 Apr 28;9(4):23259671211010826.
doi: 10.1177/23259671211010826. eCollection 2021 Apr.

Changes in Pediatric Sports Injury Presentation During the COVID-19 Pandemic: A Multicenter Analysis

Mitchell A Johnson  1 , Kenny Halloran  2 , Connor Carpenter  2 , Nicolas Pascual-Leone  1 , Andrew Parambath  1 , Jigyasa Sharma  3 , Ryan Seltzer  3 , Henry B Ellis  2 , Kevin G Shea  3 , Theodore J Ganley  1
Affiliations

Changes in Pediatric Sports Injury Presentation During the COVID-19 Pandemic: A Multicenter Analysis

Mitchell A Johnson et al. Orthop J Sports Med. .

Abstract

Background: The current coronavirus 2019 (COVID-19) pandemic has prompted a multitude of public health response measures including social distancing, school cancellations, and cessation of organized sports.

Purpose: To examine the impact of COVID-19 and corresponding public health measures on the characteristics of common pediatric musculoskeletal injuries associated with sports.

Study design: Cohort study; Level of evidence, 3.

Methods: This was a multicenter retrospective cohort study comparing patients with sports injuries presenting to 3 geographically diverse level I pediatric trauma hospitals and outpatient orthopaedic surgery clinics in the United States during the COVID-19 pandemic and a prepandemic period at the same institutions. Patients were included if they presented for care between February 15 and July 15 in 2020 (pandemic cohort) or between March 15 and April 15 in 2018 and 2019 (prepandemic cohort).

Results: Included were 1455 patients with an average age of 12.1 ± 4.5 years. When comparing patients presenting in 2018 and 2019 with those presenting in 2020, we observed a decrease in mean age during the pandemic (12.6 ± 4.0 vs 11.0 ± 5.2 years; P = .048). Additionally, a decrease in the proportion of injuries attributed to sports (48.8% vs 33.3%; P < .001) and those occurring at school (11.9% vs 4.0%; P = .001) was observed. The proportion of injuries attributable to clavicle fractures increased during the early stages of the pandemic (13.2% vs 34.7%; P < .001). There was no statistically significant delay to care in injuries presenting during the pandemic (41.5 ± 141.2 vs 19.23 ± 79.1 days; P = .175).

Conclusion: Across 3 tertiary care institutions, patients were seen without significant delay during the pandemic. We observed a significant decline in pediatric musculoskeletal injuries associated with sports during the COVID-19 pandemic. This decrease has been accompanied by a shift in both injury type and mechanism.

Keywords: COVID-19; pandemic; pediatrics; sports.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: H.B.E. has received consulting fees from Smith & Nephew, education payments from Arthrex and Pylant Medical, and speaking fees from Smith & Nephew and Synthes. K.G.S. has received education payments from Evolution Surgical and hospitality payments from Arthrex. T.J.G. has received research support from Vericel, Arthrex, and AlloSource and education payments from Liberty Surgical and is a paid associate editor for The American Journal of Sports Medicine. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Flow diagram of patient inclusion. Prepandemic group was defined as all patients presenting between March 15 and April 15, 2018; March 15 and April 15, 2019; and February 15 and March 14, 2020. The pandemic cohort was defined as all patients presenting between March 15 and July 15, 2020.
Figure 2.
Figure 2.
Proportion of injuries by age group in patients prepandemic versus those during the first month of the COVID-19 pandemic.
Figure 3.
Figure 3.
Comparison of sports injury presentations by month during the COVID-19 pandemic between February and July of 2020 and March and April of 2018 and 2019.
See this image and copyright information in PMC

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