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. 2022 Feb;57(2):284-290.
doi: 10.1016/j.jpedsurg.2021.09.054. Epub 2021 Oct 9.

Epidemiology of pediatric trauma during the coronavirus disease-2019 pandemic

Pradip P Chaudhari  1 , Melissa Anderson  2 , Shadassa Ourshalimian  2 , Catherine Goodhue  2 , Rasika Sudharshan  3 , Sara Valadez  2 , Ryan Spurrier  4
Affiliations

Epidemiology of pediatric trauma during the coronavirus disease-2019 pandemic

Pradip P Chaudhari et al. J Pediatr Surg. 2022 Feb.

Abstract

Background/purpose: We aimed to describe the epidemiology of trauma activations and variations in injury patterns, injury severity, and hospital length-of-stay for injured children in Los Angeles (LA) County during the coronavirus-disease-19 (COVID-19) pandemic.

Methods: We conducted a retrospective cross-sectional study of children aged < 18-years evaluated in 15 trauma centers from 2019 to 2020 and entered in the LA County trauma registry. We defined 01/01/2019-03/18/2020 as pre-pandemic and 03/19/2020-12/31/2020 as the pandemic period. Our primary outcome was pediatric trauma activations. We analyzed demographic and clinical data, including types and severity of injuries sustained. We conducted unadjusted bivariate analyzes of injury patterns between periods. Segmented linear regression models were used to test rates (per 100,000 LA County children) of trauma activations pre-pandemic versus the pandemic period.

Results: We studied 4399 children with trauma activations, 2695 of which occurred pre-pandemic and 1701 in the pandemic period. Motor vehicle collisions, gunshot wounds, and burns increased during the pandemic (all p-values< 0.05), while sports injuries decreased (p < 0.001). Median injury severity scores (p = 0.323) and Glasgow Coma Scales (p = 0.558) did not differ between periods, however mortality (p = 0.023) decreased during the pandemic. Segmented linear regression estimates demonstrated that rates of trauma activations pre-pandemic were similar to the pandemic period (p = 0.384).

Conclusion: Pediatric trauma activations in LA County did not significantly differ during the COVID-19 pandemic, but types and severity of injuries varied between pre-pandemic and pandemic periods. With lockdown restrictions being lifted and novel SARS-CoV-2 variants circulating, our investigation describes this recent epidemiologic phenomenon to aid future preparation for healthcare systems.

Level of evidence: Level III TYPE OF STUDY: Retrospective cross-sectional study.

Keywords: COVID-19 pandemic; Pediatric trauma.

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Conflict of interest statement

Declaration of Competing Interest None

Figures

Fig 1
Fig. 1
Monthly Los Angeles County pediatric trauma activations (rate per 100,000 children in Los Angeles County) and COVID-19 cases (rate per 100,000 people in Los Angeles County), 2019–2020.
Fig 2
Fig. 2
Monthly mechanism of injury rates (per 100,000 children in Los Angeles County), 2019–2020.
See this image and copyright information in PMC

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Supplementary concepts