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Epidemiological pattern of pediatric trauma in COVID-19 outbreak: Data from a tertiary trauma center in Iran
Mohammad Hossein Nabian1, Fardis Vosoughi1, Farid Najafi2
1Department of Orthopaedic and trauma surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Insights
The COVID-19 pandemic decreased pediatric trauma admissions in Iran, with fewer open fractures but no change in accident proportions. This suggests a need for better lockdown enforcement and resources for common COVID-era pediatric fractures.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
- Epidemiology
Background:
- The COVID-19 pandemic significantly impacted children's lives globally, including in Iran.
- A hypothesis suggested a notable change in pediatric injury patterns at trauma centers during the pandemic.
- Limited research exists on pediatric fracture epidemiology during the COVID-19 outbreak.
Purpose of the Study:
- To identify epidemiological shifts in pediatric fracture patterns.
- To compare fracture data from the COVID-19 era with pre-pandemic data (non-COVID era).
Main Methods:
- Data collected from Taleghani tertiary trauma center during the COVID era (March 1 - April 15, 2020).
- Epidemiological data included demographics, fracture types, and etiologies.
- Comparative analysis with mean data from the preceding two years (non-COVID era).
Main Results:
- Pediatric trauma admissions dropped from 589 to 288 during the COVID era.
- Distal radius, mid-forearm, and humeral supracondylar fractures were most common.
- Proportion of proximal humeral, proximal forearm, carpal, and hand fractures declined; open fractures significantly decreased (12 to 2).
Conclusions:
- Overall pediatric trauma decreased during the COVID-19 outbreak in Iran.
- The lack of reduction in accident proportions raises concerns about lockdown effectiveness.
- Findings highlight the need for resources tailored to common pediatric fractures observed during the COVID-19 era.
Introduction:
In Iran, like most other countries, COVID-19 has had a deep impact on children's lives. Our hypothesis was that, a significant change in the number of pediatric injuries has happened in trauma centers. In the current study, we intend to identify the possible epidemiological shift in pediatric fracture patterns, by comparing the data from 'COVID-19 era' and the mean data from the past 2 years. To the best of our knowledge there are only few reports on epidemiology of pediatric fractures during the COVID-19 outbreak.
Methods:
Data are reported in two sections. In the descriptive section, epidemiological data regarding pediatric fractures referred to Taleghani tertiary trauma center, including demographics, distribution curves, etiologies and fracture types are presented during the 'COVID era', from 1 March 2020 to 15 April 2020. In the comparative section, the aforementioned data are compared with mean data from the past 2 years, the 'non-COVID era'.
Results:
Altogether 117 of the 288 trauma children (40.62%) had a fractured bone (145 fractures). Patients were mostly boys, with a mean age of 9.87 years (SD=5.27). The three most common fracture types in children included distal radius, mid-forearm and humeral supracondylar fractures. Compared to non-COVID era, the number of pediatric trauma admissions dropped from 589 to 288. No significant change happened in the mean age, male/female ratio and percentage of motor vehicle accidents. Proportion of proximal humeral, proximal forearm, carpal, and hand fractures declined. The number of open fractures significantly dropped (from 12 to 2).
Conclusions:
In Iran, overall trend of pediatric trauma has been decreasing during the outbreak; but the lack of reduction in proportion of accidents may pose an alarm that an effective lock-down has not been imposed. This study has implications as to preparing appropriate resources particular to common "COVID era fractures".
