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Published on: November 7, 2020
Epidemiology of pediatric trauma during the coronavirus disease-2019 pandemic
Pradip P Chaudhari1, Melissa Anderson2, Shadassa Ourshalimian2
1Division of Emergency and Transport Medicine, Department of Pediatrics, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mail Stop 113, Los Angeles, CA 90027, USA; Keck School of Medicine of the University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033, USA.
Insights
Pediatric trauma activations in Los Angeles County remained stable during the COVID-19 pandemic. However, injury types shifted, with increases in motor vehicle collisions and gunshot wounds, and decreases in sports injuries.
Area of Science:
- Pediatric trauma epidemiology
- Public health during pandemics
- Injury patterns in children
Background:
- The coronavirus disease-19 (COVID-19) pandemic significantly impacted healthcare systems globally.
- Understanding the epidemiology of pediatric trauma during this period is crucial for public health preparedness.
Purpose of the Study:
- To describe pediatric trauma activations in Los Angeles County during the COVID-19 pandemic.
- To analyze variations in injury patterns, severity, and hospital length-of-stay for injured children.
- To compare pre-pandemic and pandemic periods regarding trauma epidemiology.
Main Methods:
- Retrospective cross-sectional study of children (<18 years) in 15 LA County trauma centers (2019-2020).
- Defined pre-pandemic (01/01/2019-03/18/2020) and pandemic (03/19/2020-12/31/2020) periods.
- Analyzed trauma activations, injury types, severity (Injury Severity Score, Glasgow Coma Scale), and mortality using bivariate and segmented linear regression.
Main Results:
- 4399 pediatric trauma activations studied; 2695 pre-pandemic, 1701 during the pandemic.
- Increased rates of motor vehicle collisions, gunshot wounds, and burns; decreased sports injuries during the pandemic (p<0.05).
- No significant difference in injury severity scores or Glasgow Coma Scale; decreased mortality observed during the pandemic (p=0.023).
- Trauma activation rates remained similar between pre-pandemic and pandemic periods (p=0.384).
Conclusions:
- Pediatric trauma activations in LA County did not significantly change during the COVID-19 pandemic.
- Significant shifts in injury types and patterns were observed.
- Findings aid healthcare system preparation for future public health crises and evolving epidemiologic phenomena.
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.
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