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Multicenter Study
. 2022 Jul;57(7):1370-1376.
doi: 10.1016/j.jpedsurg.2022.03.034. Epub 2022 Apr 12.

The COVID-19 pandemic and associated rise in pediatric firearm injuries: A multi-institutional study

Amelia T Collings  1 , Manzur Farazi  2 , Kyle J Van Arendonk  2 , Mary E Fallat  3 , Peter C Minneci  4 , Thomas T Sato  2 , K Elizabeth Speck  5 , Katherine J Deans  4 , Richard A Falcone Jr  6 , David S Foley  3 , Jason D Fraser  7 , Samir K Gadepalli  5 , Martin S Keller  8 , Meera Kotagal  6 , Matthew P Landman  9 , Charles M Leys  10 , Troy A Markel  9 , Nathan Rubalcava  5 , Shawn D St Peter  7 , Katherine T Flynn-O'Brien  2 ; Midwest Pediatric Surgery Consortium
Affiliations
Multicenter Study

The COVID-19 pandemic and associated rise in pediatric firearm injuries: A multi-institutional study

Amelia T Collings et al. J Pediatr Surg. 2022 Jul.

Abstract

Background: Firearm sales in the United States (U.S.) markedly increased during the COVID-19 pandemic. Our objective was to determine if firearm injuries in children were associated with stay-at-home orders (SHO) during the COVID-19 pandemic. We hypothesized there would be an increase in pediatric firearm injuries during SHO.

Methods: This was a multi institutional, retrospective study of institutional trauma registries. Patients <18 years with traumatic injuries meeting National Trauma Data Bank (NTDB) criteria were included. A "COVID" cohort, defined as time from initiation of state SHO through September 30, 2020 was compared to "Historical" controls from an averaged period of corresponding dates in 2016-2019. An interrupted time series analysis (ITSA) was utilized to evaluate the association of the U.S. declaration of a national state of emergency with pediatric firearm injuries.

Results: Nine Level I pediatric trauma centers were included, contributing 48,111 pediatric trauma patients, of which 1,090 patients (2.3%) suffered firearm injuries. There was a significant increase in the proportion of firearm injuries in the COVID cohort (COVID 3.04% vs. Historical 1.83%; p < 0.001). There was an increased cumulative burden of firearm injuries in 2020 compared to a historical average. ITSA showed an 87% increase in the observed rate of firearm injuries above expected after the declaration of a nationwide emergency (p < 0.001).

Conclusion: The proportion of firearm injuries affecting children increased during the COVID-19 pandemic. The pandemic was associated with an increase in pediatric firearm injuries above expected rates based on historical patterns.

Keywords: 2020; COVID-19; Firearm violence; Gun violence; Pandemic; Pediatric trauma.

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Conflict of interest statement

Declaration of Competing Interest The authors have no financial disclosures. The study had no source of funding.

Figures

Fig 1
Fig. 1
(a) Frequency of firearm injuries by month across all sites with a LOESS smoothing line; (b) Cumulative firearm injuries by month across all sites.
Fig 2
Fig. 2
Interrupted time series with the interruption point representing the declaration of state of emergency in the U.S. (March 13, 2020).
See this image and copyright information in PMC

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