Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2023 Aug;58(8):1500-1505.
doi: 10.1016/j.jpedsurg.2022.10.007. Epub 2022 Oct 22.

COVID-19 Pandemic Effects on the Epidemiology and Mortality of Pediatric Firearm Injuries; A Single Center Study

Mary Elizabeth Bernardin  1 , Lindsay Clukies  2 , Hongjie Gu  3 , Connor Fairfax  4 , Martin S Keller  5
Affiliations
Observational Study

COVID-19 Pandemic Effects on the Epidemiology and Mortality of Pediatric Firearm Injuries; A Single Center Study

Mary Elizabeth Bernardin et al. J Pediatr Surg. 2023 Aug.

Abstract

Background: The COVID-19 pandemic has been associated with increased firearm injuries amongst adults, though the pandemic's effect on children is less clearly understood.

Methods: This cross-sectional study was performed at a Level 1 Pediatric Trauma Center and included youths 0-19 years. The trauma registry was retrospectively queried for firearm injuries occurring pre-COVID-19 pandemic (March 2015-February 2020). Baseline data was compared to prospectively collected data occurring during the COVID-19 pandemic (March 2020-March 2022). Fischer's exact, Pearson's Chi-square and/or correlation analysis was used to compare pre and post-COVID-19 firearm injury rates and intent, victim demographics and disposition. Temporal relationships between firearm injury rates and local COVID-19 death rates were also described.

Results: 413 pre-COVID-19 firearm injuries were compared to 259 pandemic firearm injuries. Victims were mostly Black males with a mean age of 13.4 years. Compared to the 5 years pre-pandemic, monthly firearm injury rates increased 51.5% (6.8 vs 10.3 shootings/month), including a significant increase (p = 0.04) in firearm assaults/homicides and a relative decrease in unintentional shootings. Deaths increased 29%, and there were significantly fewer ED discharges and more admissions to OR and/or PICU (p = 0.005). There was a significant increase in Black victims (p = 0.01) and those having Medicaid or self-pay (p<0.001). Firearm injury spikes were noted during or within the 3 months following surges in local COVID-19 death rates.

Conclusions: The COVID-19 pandemic was associated with an increase in the frequency and mortality of pediatric firearm injuries, particularly assaults amongst Black children following surges in COVID death rates. Increased violence-intervention services are needed, particularly amongst marginalized communities.

Level of evidence: This is a prognostic study, evaluating the effects of the COVID-19 pandemic on pediatric firearm injuries, including victim demographics, injury intent and mortality. This study is retrospective and observational, making it Oxford Level III evidence.

Keywords: COVID-19 pandemic; Firearm injury; Gun violence; Pediatric injury prevention.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest All authors declare no conflict of interest related to this work.

Figures

Fig. 1:
Fig. 1
Average monthly pediatric firearm injuries by intent, March 2015-March 2022.
Fig. 2:
Fig. 2
Pediatric firearm assaults (FA) and COVID-19 deaths per month in St. Louis, MO (March 2020-March 2022).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Neufeld M.Y., Poulson M., Stolarski A.E., Dunnington C., Burke P.A., Allee L. Amplifying inequity: the compounding impact of COVID-19 and violence. J Natl Med Assoc. 2021;113:528–530. doi: 10.1016/j.jnma.2021.04.003. - DOI - PMC - PubMed
    1. Sutherland M., McKenney M., Elkbuli A. Gun violence during COVID-19 pandemic: paradoxical trends in New York City, Chicago, Los Angeles and Baltimore. Am J Emerg Med. 2021;39:225–226. doi: 10.1016/j.ajem.2020.05.006. - DOI - PMC - PubMed
    1. Ng G., Castro C.M., Hamdan M., Salazar H., Joseph S., Thakur B., et al. Evaluating the change in patterns of traumatic injury in the setting of pandemic and social distancing restrictions: an analysis of a level 1 trauma center. Am J Surg. 2022 doi: 10.1016/j.amjsurg.2022.03.033. - DOI - PMC - PubMed
    1. Abdallah H.O., Zhao C., Kaufman E., Hatchimonji J., Swendiman R.A., Kaplan L.J., et al. Increased Firearm Injury During the COVID-19 Pandemic: a Hidden Urban Burden. J Am Coll Surg. 2021;232:159–168. doi: 10.1016/j.jamcollsurg.2020.09.028. e3. - DOI - PMC - PubMed
    1. McGraw C., Jarvis S., Carrick M., Lieser M., Madayag R.M., Berg G.M., et al. Examining trends in gun violence injuries before and during the COVID-19 pandemic across six trauma centers. Trauma Surg Acute Care Open. 2022;7:1–5. doi: 10.1136/tsaco-2021-000801. - DOI - PMC - PubMed

Publication types