Related Experiment Video
Updated: Sep 29, 2025
An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
Published on: November 30, 2022
Impact of the First COVID Lockdown on Accident- and Injury-Related Pediatric Intensive Care Admissions in Germany-A
Nora Bruns1, Lea Y Willemsen1, Katharina Holtkamp1
1Department of Pediatrics I, Pediatric Intensive Care Medicine, University Medicine Essen, University of Duisburg-Essen, 45147 Essen, Germany.
Insights
COVID-19 lockdowns shifted childhood accidents, with fewer traffic and school incidents but more household and leisure injuries. Pediatric intensive care unit admissions for trauma saw changes, and adolescent boys showed an increase in suicide attempts.
Area of Science:
- Pediatric Intensive Care
- Trauma Surgery
- Public Health
Background:
- The COVID-19 pandemic and associated lockdowns significantly altered daily life for children and adolescents globally.
- Understanding the impact on pediatric injury patterns and healthcare utilization is crucial for public health responses.
Purpose of the Study:
- To compare pediatric intensive care unit (PICU) admissions for accidents and injuries during Germany's first COVID-19 lockdown with pre-pandemic years (2017-2019).
- To analyze changes in the types of accidents, injury mechanisms, surgical interventions, and non-accidental injuries.
Main Methods:
- A retrospective multicenter study involving 37 German PICUs.
- Data collected on accident/injury admissions during the first COVID-19 lockdown and matched periods from 2017-2019.
- Standardized morbidity ratios (SMR) were calculated to compare admission rates.
Main Results:
- Overall PICU admissions for accidents/injuries slightly declined (SMR 0.95).
- Trauma admissions increased (SMR 1.07), with decreases in traffic and school/kindergarten accidents, but increases in household and leisure accidents.
- Significant shifts in surgical interventions were observed, including fewer neurosurgeries and more visceral surgeries. Non-accidental injuries decreased, while suicide attempts rose in adolescent boys.
Conclusions:
- COVID-19 lockdowns altered pediatric trauma mechanisms, leading to changes in injury types and surgical needs.
- No evidence suggested an increase in child abuse requiring intensive care.
- The rise in suicide attempts among adolescent boys warrants further investigation and targeted interventions.
Abstract:
Children's and adolescents' lives drastically changed during COVID lockdowns worldwide. To compare accident- and injury-related admissions to pediatric intensive care units (PICU) during the first German COVID lockdown with previous years, we conducted a retrospective multicenter study among 37 PICUs (21.5% of German PICU capacities). A total of 1444 admissions after accidents or injuries during the first lockdown period and matched periods of 2017-2019 were reported and standardized morbidity ratios (SMR) were calculated. Total PICU admissions due to accidents/injuries declined from an average of 366 to 346 (SMR 0.95 (CI 0.85-1.05)). Admissions with trauma increased from 196 to 212 (1.07 (0.93-1.23). Traffic accidents and school/kindergarten accidents decreased (0.77 (0.57-1.02 and 0.26 (0.05-0.75)), whereas household and leisure accidents increased (1.33 (1.06-1.66) and 1.34 (1.06-1.67)). Less neurosurgeries and more visceral surgeries were performed (0.69 (0.38-1.16) and 2.09 (1.19-3.39)). Non-accidental non-suicidal injuries declined (0.73 (0.42-1.17)). Suicide attempts increased in adolescent boys (1.38 (0.51-3.02)), but decreased in adolescent girls (0.56 (0.32-0.79)). In summary, changed trauma mechanisms entailed different surgeries compared to previous years. We found no evidence for an increase in child abuse cases requiring intensive care. The increase in suicide attempts among boys demands investigation.
