Epidemiology of pediatric trauma during the COVID-19 pandemic shelter in place

Abstract

Introduction: The first COVID-19 cases occurred in the US in January of 2020, leading to the implementation of shelter in place. This study seeks to define the impact of shelter in place on the epidemiology of pediatric trauma.

Methods: We examined pediatric trauma admissions at 5 Level 1 and 1 Level 2 US pediatric trauma centers between January 1 and June 30, 2017-2020. Demographic and injury data were compared between pre- and post-shelter in place patient cohorts.

Results: A total of 8772 pediatric trauma activations were reviewed. There was a 13% decrease in trauma volume in 2020, with a nadir at 16 days following implementation of shelter in place. Injury severity scores were higher in the post-shelter in place cohort. The incidence of nonmotorized vehicle accidents and gunshot wounds increased in the post-shelter in place cohort.

Conclusion: We found an overall decrease in pediatric trauma volume following shelter in place. However, injuries tended to be more severe. Our findings help inform targeted injury prevention campaigns during future pandemics.

Fig 1

Daily trauma volume aggregated from 6 pediatric trauma centers across the US from January to June, 2017–2020. Dates on the horizontal axis were normalized relative to the shelter-in-place order for each center's county; trauma volume was plotted using a 7-day running average. The shaded area marks the 30-day period which saw the most significant change in pediatric trauma volume. P value was calculated using Fisher exact test to compare volume in 2020 to historical controls.

Fig 2

Daily trauma volume by state for 6 pediatric trauma centers across the US from January to June, 2017–2020. Dates on the horizontal axis were normalized relative to the shelter-in-place order for each center's county; trauma volume was plotted using a 7-day running average. The shaded areas mark the 30-day periods which saw the most significant change in pediatric trauma volume for each state. P value was calculated using Fisher exact test to compare volume in 2020 to historical controls.