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Impact of Earthquakes During COVID-19 Lockdown on the Pediatric Injury Pattern in the Zagreb Urban Area
Dino Bobovec1, Tomislav Žigman1,2, Josip Lovaković1
1Department of Surgery, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia.
Insights
During the COVID-19 lockdown, an earthquake in Zagreb altered pediatric injury patterns. Fewer children were referred to the emergency department, with more head and upper limb injuries observed.
Area of Science:
- Pediatric Emergency Medicine
- Trauma Epidemiology
- Disaster Medicine
Background:
- Previous studies noted decreased pediatric trauma referrals during COVID-19 lockdowns.
- The impact of concurrent natural disasters, like earthquakes, on pediatric trauma during lockdowns remains understudied.
- This research addresses the unique intersection of a pandemic lockdown and seismic activity on pediatric injury patterns.
Purpose of the Study:
- To investigate the influence of earthquakes during the COVID-19 lockdown on pediatric injury referrals.
- To analyze changes in the pattern of pediatric injuries in an urban tertiary care setting.
- To provide data for restructuring health resources during similar public health crises.
Main Methods:
- Retrospective single-center case-control study.
- Comparison of pediatric trauma patients during the COVID-19 lockdown with an earthquake (March 22-April 27, 2020) versus the same period in 2019.
- Analysis of demographics and injury characteristics for 1166 patients referred to the Pediatric Emergency Department.
Main Results:
- A decrease in Pediatric Emergency Department referrals and a reduced proportion of pediatric trauma patients were observed during the lockdown/earthquake period.
- The median age of injured children was lower during the case period compared to the control period.
- An increased proportion of shoulder/elbow and head injuries, and a decreased proportion of foot/ankle injuries were noted.
Conclusions:
- The combination of earthquakes and COVID-19 lockdown significantly altered pediatric injury referral patterns.
- Findings highlight the need for adaptable healthcare resource allocation during concurrent crises.
- Understanding these shifts is crucial for optimizing pediatric care during pandemics and natural disasters.
Abstract:
Background/Objectives: Previous works on the epidemiology of pediatric trauma during the COVID-19 lockdown observed a decrease in pediatric surgical emergency consultations and fracture referrals. None of those works describes a unique situation in which there is the coexistence of another opposing factor, like an earthquake, that influences the number of injured children's referrals. Therefore, this study aimed to investigate the influence of earthquakes during the COVID-19 lockdown on pediatric injury pattern referrals at a tertiary care hospital in a urban setting. Methods: A retrospective single-center case-control study comprised a time interval at the time of the COVID-19 lockdown, starting with a day when the biggest earthquake happened and finishing at the end of the confinement period in Zagreb, Croatia (22 March-27 April 2020). The control group comprised the identical time interval in 2019. We identified all successive pediatric trauma patients referred to the Pediatric Emergency Department. Demographics and leading injury characteristics were analyzed. Results: We analyzed data from 1166 patients. In the case group, the median age was lower than in the control group but without gender differences. We detected a decrease in Pediatric Emergency Department referrals and a reduced proportion of pediatric trauma patients in the case group. Additionally, the proportion of shoulder/elbow injuries and head injuries was higher, and the proportion of foot/ankle injuries was lower in the case period than in the control period. Conclusions: Earthquakes during the COVID-19 lockdown changed the pattern of pediatric injuries. These data can be used to restructure health resources during similar conditions to provide optimal health care to children.
