Changes in pediatric trauma during the COVID-19 pandemic; Does the pandemic have an effect on the severity of traumas?

INTRODUCTION: Traumas are the most common cause of mortality and morbidity in children.COVID-19 was shown to affect pediatric mental health, child neglect, and the occurrence of traumatic injuries. This study aimed to characterize pediatric trauma cases presented in our institution before and after the pandemic.
METHODS: Patients with trauma who were admitted to our emergency department between March-2019 and March-2021 were included. Patients were classified into two groups as before and after the pandemic (March-2020). Trauma characteristics, the severity of the injury, and the prognosis were assessed. Patients’ injury severity score (ISS) and pediatric trauma score (PTS) were noted.
RESULTS: A total of 1718 patients were included in the study. The number of pediatric trauma admissions dropped from 1039 to 679 after the pandemic started. There was no difference between these groups in terms of age (p=0.874) or gender (p=0.106). There was a significant decrease in the number of traumatic injuries (p<0.001) especially during the first shutdown period (April, May, and June 2020. On the contrary, there was a significant increase in terms of foreign body aspiration (p=0.001) and pedestrian injury (p=0.016). Although a significant increase was noted in the ISS of the patients(p<0.001), no difference was found between the PTSs (p=0.075) and multi-organ injuries(p=1.000). Also, no significant difference was observed regarding mortality(p=0.650), household accidents(p=0.600), trauma type(p=0.533), need for transfusion(p=0.166), surgery(p=0.077) or mechanical ventilation(p=0.464) between both groups.
DISCUSSION AND CONCLUSION: COVID-19 pandemic altered social patterns, leading to a decrease in pediatric traumas. This decrease was most prominent during the shutdown period. The variables showing severe trauma such as the need for surgery did not change, despite a significant increase in ISS. This was attributed to a decrease in admissions for minor trauma.