34 - Effects of the COVID-19 Pandemic on Pediatric Trauma in Saint Louis: Data From the Three Largest Pediatric Hospitals

Poster Number: 34
Publication Number: 34.406

Signia M. Camacho-Velez, SSM Cardinal Glennon Children's Medical Center, St louis, MO, United States; Rachel Charney, Saint Louis University School of Medicine, Saint Louis, MO, United States; James M. Gerard, Saint Louis University School of Medicine, St. Louis, MO, United States

Background: Trauma is a significant cause of mortality and disability in the pediatric population, responsible for more deaths than all diseases combined. Rates of injuries have been shown to fluctuate from year to year, but also have a seasonal variation. The onset of the COVID-19 pandemic provides a novel opportunity to examine impact of infectious disease outbreaks on pediatric trauma. Determining how a global pandemic influences pediatric trauma may help reflect on necessary resources and direct interventions.

Objective: The primary goal of this study is to compare and describe changes in incidence, mechanisms of injury (MOI), and severity of the traumas presenting during the period of the COVID-19 pandemic.

Design/Methods: A multicenter retrospective cohort study was conducted by reviewing the trauma registry of the three largest pediatric hospitals serving the metropolitan Saint Louis region. Population included patients < 18 years, presenting with blunt, penetrating or burn injury to the ED from March 2020 to February 2021 during the COVID-19 outbreak, compared to 2018 and 2019. March was selected as start of study period since the novel coronavirus was declared a global pandemic during that month. February marks the end of a 12-month period. Patients >18 years were excluded. The study period was further divided in 6-month periods for part of the analysis. Data collected included demographics, MOI, and injury severity score (ISS).

Results: There were 3614 pediatric trauma encounters during the COVID-19 epoch as compared to 6234 during the pre-COVID-19 epoch. The percentage of trauma visits was higher (5.3%) during the pandemic versus the pre-pandemic period (2.6%). Patients were older during the pandemic period (median=9, IQR 4-14) in comparison to pre-pandemic period (median=8, IQR 3-13, p=0.001). There was an increase in penetrating injury from 11.1% during the pre-pandemic period to 14.4% during the COVID-19 pandemic (p= < 0.001). No significant differences in gender and injury severity were detected.Conclusion(s): During the COVID-19 pandemic there was an increase in penetrating trauma in the Saint Louis region. This aligns with previous findings in literature of a firearm injury surge following pandemic onset. Factors specific to the pandemic, such as physical and psychosocial stress, and financial strain, may exacerbate this rise. Additionally, ED visits for trauma did not drop off as medical visits did.
Incidence and Evolution of Different Mechanisms of Injury Before and During the COVID-19 Pandemic