Traumatic brain injuries in children during COVID-19 pandemic: a national report from northern Iran
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Updated: Aug 27, 2025

Controlled Cortical Impact Model for Traumatic Brain Injury
Published on: August 5, 2014
Zoheir Reihanian1, Nazanin Noori Roodsari2, Siamak Rimaz3
1Road Trauma Research Center, Department of Neurosurgery, School of Medicine, Guilan University of Medical Sciences Rasht, Iran.
Insights
Pediatric traumatic brain injury referrals remained stable during the COVID-19 pandemic. However, a significant decrease in head/neck injuries was observed in children under six years old during this period.
Area of Science:
- Pediatric Traumatology
- Neuroscience
- Epidemiology
Background:
- Traumatic injury referrals decreased during the COVID-19 pandemic.
- Limited data exists on pediatric traumatic brain injury (TBI) referrals during the pandemic.
- This study describes the epidemiological and clinical features of pediatric TBIs.
Purpose of the Study:
- To describe the epidemiological and clinical features of pediatric traumatic brain injuries.
- To compare the prevalence of pediatric TBI before and during the COVID-19 pandemic.
Main Methods:
- Cross-sectional study of pediatric patients (<15 years) with head trauma.
- Retrospective data collection from hospital records and a trauma information system.
- Study conducted at a referral center in northern Iran.
Main Results:
- Overall prevalence of head/neck injuries was 30.6% (166/543).
- No significant difference in head/neck injury prevalence between pre-COVID-19 (32.1%) and COVID-19 (24.3%) periods (P=0.243).
- Significant decrease in head/neck injuries observed in children under 2 years (55.6% vs 37.5%, P=0.013) and 2-6 years (45.8% vs 30.0%, P=0.036) during COVID-19.
Conclusions:
- Pediatric traumatic brain injury admissions did not significantly change during the COVID-19 pandemic.
- A notable decrease in pediatric brain trauma referrals was observed in children under six years old during the COVID-19 period.
- Findings highlight a specific age-related trend in pediatric TBI during the pandemic.
Background:
Evidence suggests that referral cases of traumatic injuries have decreased during the COVID-19 pandemic both in childhood and in adulthood. Still we have very little evidence of referrals due to traumatic brain injury among children during the COVID-19 outbreak. The present study aimed to describe epidemiological and clinical features of pediatric traumatic brain injuries.
Methods:
This cross-sectional study was performed on all patients under 15 years with any evidence of head trauma, referring to Poursina teaching hospital, a referral center for trauma and road accidents in northern Iran. The patients' data were retrospectively collected by reviewing the hospital recorded files and the trauma-specific hospital information system.
Results:
Of all 543 pediatric traumatic injuries referred to our hospital during the two pointed periods, 166 had any evidence of head and neck injuries leading to an overall prevalence rate of 30.6%. In this regard, the prevalence rate of head/neck injuries was estimated to be 140 out of 436 within a pre-COVID-19 period (32.1%) and 26 out of 107 within the COVID-19 period (24.3%) indicating no significant difference between the two time periods (P = 0.243). However, assessing the rate of head/neck injuries pre-COVID-19 and COVID-19 periods according to patients' age showed a higher rate of such injuries in pre-COVID-19 as compared to COVID-19 periods in patients aged less than two years (55.6% versus 37.5%, P = 0.013) as well as aged 2 to six years (45.8% versus 30.0%, P = 0.036).
Conclusion:
The rate of admission of children due to traumatic brain injury during the COVID-19 period does not show a significant change compared to before, and only in children under 6 years of age a decrease in referrals due to brain trauma during the COVID-19 period was observed.

