Evaluating the regional differences in pediatric injury patterns during the COVID-19 pandemic

ABSTRACT

Background Reports of pediatric injury patterns during the COVID-19 pandemic are conflicting and lack the granularity to explore differences across regions. We hypothesized there would be considerable variation in injury patterns across Pediatric Trauma Centers (PTCs) in the United States. Materials and Methods A multicenter, retrospective study evaluating patients <18-years-old with traumatic injuries meeting National Trauma Data Bank criteria was performed. Patients injured after Stay-at-Home Orders through September 2020 ("COVID” cohort) were compared to "Historical” controls from an averaged period of equivalent dates in 2016–2019. Differences in injury type, intent, and mechanism were explored at the site level. Results 47,385 pediatric trauma patients were included. Overall trauma volume increased during the COVID cohort compared to the Historical (COVID 7,068 patients vs. Historical 5,891 patients);however, some sites demonstrated a decrease in overall trauma of 25% while others had an increase over 33%. Bicycle injuries increased at every site, with a range in percent change from 24% to 135% increase. Although the greatest net increase was due to blunt injuries, there was a greater relative increase in penetrating injuries at 7/9 sites, with a range in percent change from 110% increase to a 69% decrease. Conclusions There was considerable discrepancy in pediatric injury patterns at the individual site level, perhaps suggesting a variable impact of the specific sociopolitical climate and pandemic policies of each catchment area. Investigation of the unique response of the community during times of stress at PTCs is warranted to be better prepared for future environmental stressors.