Quantifying the impact of the coronavirus 2019 pandemic on youth sports-related injuries in the USA.

The purpose of this study was to estimate monthly and annual trends in youth sports-related injury over the years 2016-2020 using the National Electronic Injury Surveillance System (NEISS) database to measure the impact of COVID-19 on overall and sport-specific rates of injury. Children and adolescents (0-19 years) presenting to USA emergency departments with sport participation injury from 2016 to 2020 were identified. Descriptive statistical analyses were performed of injury patterns. An interrupted time series analysis was applied to estimate changes in injury trends during COVID-19. Proportional changes in injury characteristics during this period were examined. An estimated 5 078 490 sports-related injuries were identified with an annual incidence of 1406 injuries per 100 000 population. Seasonal peaks in injuries occurred during September and May. About 58% of injuries were associated with contact sports, such as basketball, football, and soccer, and the most common injuries were sprains and strains. After the pandemic onset, there was a statistically significant 59% decrease in national youth sports-related injuries compared with the average estimates for 2016-2019. While the distribution of injury characteristics did not appear to change, the location of injury appeared to shift away from school toward alternative settings. A significant reduction in youth sports-related injuries was identified in 2020 coinciding with the COVID-19 pandemic, persisting throughout the rest of the year. No changes in the anatomic or demographic distribution of injuries were identified. This study expands our epidemiologic understanding of youth sports-related injury trends and how they changed following the pandemic onset.

The Epidemiology of Pediatric Basketball Injuries Presenting to US Emergency Departments: 2011-2020.

OBJECTIVES: The purpose of this study is to describe the national epidemiology of basketball-related injuries in children and adolescents presenting to US emergency departments (EDs) from 2011 to 2020 and to quantify the effect of the COVID-19 pandemic. METHODS: The National Electronic Injury Surveillance System database was queried for cases of injury in persons aged 0 to 19 years related to product code 1205 (basketball and related equipment) presenting from January 1, 2011 to December 31, 2020. National injury estimates were calculated using National Electronic Injury Surveillance System-recommended weights and strata. The US Census data were used to determine the incidence of injury by age group and by sex. To quantify the effect of COVID-19, an interrupted time series analysis was performed using March 1, 2020 as the interrupting time point. The pre-COVID-19 trend was used to estimate the difference in injuries attributable to the COVID-19 pandemic. RESULTS: From 2011 to 2020, an estimated 3,210,953 (95% confidence interval = 2,655,812-3,788,094) visits were made to US EDs for basketball-related injuries in those aged younger than 20 years, corresponding to a mean annual incidence of 391 injuries per 100,000 population. The mean age of injury was 14.4 years (95% confidence interval = 14.3-14.5). Boys were more often injured than girls (76% vs 24% of all injuries, respectively). The foot was the most injured body part, accounting for 24% of injuries. Strains or sprains were the most common injury type (38% of injuries). During the COVID-19 pandemic, there were 155,638 fewer injuries than were expected based on pre-COVID-19 trends. During COVID-19, there were no significant differences in the proportions of injury types, body parts involved, sex, or age. CONCLUSIONS: Basketball remains a frequent cause of injury, especially in adolescents. The COVID-19 pandemic profoundly reduced the frequency of basketball-related injuries, but did not affect the type and body location of injuries presenting to the ED.

Trends in Pediatric ACL Reconstruction: The impact of COVID-19.

CONTEXT: The number of pediatric anterior cruciate ligament reconstructions (ACLRs) occurring yearly increased almost 6-fold from 2004 to 2014. Interestingly, there are limited recent data on rates of ACL injury and reconstruction in children and adolescents, especially in the context of COVID-19. OBJECTIVE: Given the impact of the COVID-19 pandemic on youth sports seasons and the postponement of many elective surgeries, we sought to examine the changes in rates of ACLR during this period. DESIGN: Retrospective cohort study. SETTING: This study used the Pediatric Health Information System (PHIS) database to identify eligible patients at PHIS-participating hospitals nationwide from January 2016 to June 2021, with March 1, 2020 considered the "start" of the COVID-19 pandemic. PATIENTS OR OTHER PARTICIPANTS: Using CPT codes, patients 18 years old and younger who underwent ACLR surgery were identified. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Patient demographics and overall rates of surgery pre- and intra-pandemic were compared. Data were analyzed using bivariate, mixed model, and time series analyses. RESULTS: A total of 24,843 ACLRs were identified during this time period. In total, 1,853 fewer surgeries were performed after March 2020 than expected given pre-pandemic trends. Examining demographics, intra-pandemic, there was an increase in the proportion of patients who identified as White and with private insurance and a decrease in the proportion who identified as Black and with public insurance. There was also a significant shift in the proportion of ACLRs by region, with increased surgeries performed in the Midwest and decreased in the Northeast. In the model adjusted for hospital-level variability, only race and insurance status remained significant. CONCLUSIONS: Based on pre-pandemic trends, there were fewer patients than projected who underwent ACLR once the pandemic began, likely due to a combination of decreased rates of injury and delayed surgery.

Track and Field Injuries in Children and Adolescents Presenting to us Emergency Departments-An Updated Review of the National Electronic Injury Surveillance System

Background: Running is a highly popular activity that fosters healthy lifestyle habits in athletes of all ages. Track and field is a popular competitive youth sport with injuries estimated at 0.84 per 1000 athlete exposures among high school athletes. Injury patterns have been noted to vary by age and differ from those sustained in adult runners. Prior work has examined the epidemiology of youth track and field and running related injuries, but data from the recent decade in the setting of increasing sport specialization and year-round participation is lacking. Purpose: To examine the evolving epidemiology of track and field and running related injuries prompting emergency department presentation. Methods: A retrospective review of data obtained from the National Electronic Injury Surveillance System (NEISS) database was performed identifying children 10-18 with injuries associated with the Track & Field/Running product code (5030) from 2008-2020. National injury estimates were calculated annually and overall. Descriptive statistics were utilized to summarize injury characteristics of the entire cohort. Annual injury estimates were calculated to identify trends over the study period, which included the 2020 season interrupted by the COVID-19 pandemic. Results: We identified 8,399 track and field associated NEISS cases occurring from 2008-2020 representing a national estimate of 271,788 injuries [95% Confidence Interval: 250,288 to 294,24]. The majority (52%) of injuries occurred among patients 15 to 18 years of age. Injuries occurred most frequently in the lower extremity (52%) and most commonly involved the ankle (17%) and knee (15%). Sprain/strains were the most frequent injury type (40%). The majority of patients (97%) did not require hospitalization. Injury estimates of each demographic and injury characteristic with 95% confidence intervals are reported in Table 1. There was a rising annual frequency of track and field injuries seen peaking in 2017 with a notable decline in 2020 during the COVID-19 pandemic. Conclusion: Track and field injuries requiring emergency department presentation appear to be increasing from prior study estimates, but demonstrate similar distribution of injury characteristics. Severe injuries requiring hospitalization remain rare. The majority of injuries involve the knee and ankle and involve older adolescents. This data provides meaningful data for providers caring for and counseling adolescent athletes.Table 1: Track-Related Injuries in Children aged 10-18 Treated in US Emergency Departments