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Trends in Pediatric Mild Traumatic Brain Injury During COVID-19-Related Lockdown-A Single-Center Study
Hanna E Kläger1,2, Benjamin Nast-Kolb1,2, Lea Reuter3
1Department of Pediatric Neurology and Developmental Medicine, LMU Hospital, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany.
Insights
The coronavirus lockdown significantly reduced pediatric mild traumatic brain injury (mTBI) visits. However, the mTBI cases that did present were more severe, with higher hospital admission and intracranial pathology rates.
Area of Science:
- Pediatric Emergency Medicine
- Neuroscience
- Public Health
Background:
- Pediatric emergency departments (pED) frequently manage mild traumatic brain injury (mTBI) cases.
- The first full lockdown (LD) in Bavaria due to the COVID-19 pandemic began on March 16, 2020.
Purpose of the Study:
- To investigate the impact of the COVID-19 lockdown on pediatric mild traumatic brain injury (mTBI) presentations.
Main Methods:
- A retrospective chart review of pediatric mild traumatic brain injury (mTBI) cases presenting to the pED.
- Comparison of mTBI cases during the lockdown period (March 17–May 5, 2020) with reference periods in 2017, 2018, and 2019.
- Statistical analysis using Chi-square or Fisher's exact test.
Main Results:
- Pediatric mTBI cases were halved during the lockdown.
- A higher proportion of mTBI cases were due to falls at home.
- Increased rates of hospital admission, intensive care unit admission, longer hospital stays, and intracranial pathologies were observed during the lockdown.
Conclusions:
- The reduction in mTBI presentations may be due to fewer incidents and parental hesitation to seek care amid pandemic fears.
- The mTBI cases that did present during the lockdown represented a more severe spectrum of injury.
Background:
A relevant number of visits to pediatric emergency departments (pED) are associated with mild traumatic brain injury (mTBI). On March 16, 2020, the Bavarian government declared a first full lockdown (LD) related to the coronavirus (COVID-19) pandemic.
Aim:
The aim of the study was to investigate the impact of LD on pediatric mTBI.
Methods:
Retrospective chart review of presentations to a pED due to mTBI. Study periods covered LD (03/17/2020 through 05/05/2020) and the same time in 2017, 2018, and 2019 as reference period (RP). Comparative analyses were performed by Chi-square or Fisher's exact test.
Results:
Numbers of mTBI cases decreased by half. Age distribution did not differ. A significantly higher proportion of mTBI were related to falls at home (p = 0.001). Further, a higher rate of hospital admissions (p = 0.03), a higher proportion of intensive care unit admissions (p = 0.001), a longer duration of hospital stay (p = 0.02), and a higher rate of intracranial pathologies on neuroimaging were observed during LD (p = 0.007).
Conclusion:
The decrease in mTBI presentations is likely due to an absolute decrease in numbers related to the LD measures, combined with a hesitation to present very minor mTBI to the hospital, because of fear of being infected or not to put additional strain on the healthcare system during this healthcare crisis. On the other hand, data of those that presented with mTBI tend to reflect the more severe spectrum of mTBI.
