Pediatric trauma volume fell during the initial COVID-19 wave but rebounded to new highs for the remainder of 2020.

Background: Previous studies have shown a reduction in pediatric trauma volume during COVID-19, but many have looked at a limited number of facilities, analyzed a narrow timeframe, or both. The objective of this analysis was to assess the impact of COVID-19 on pediatric trauma volume for a statewide sample during 2020. Based on previous literature, researchers hypothesized a reduction in volume during the implementation of these policies.

Methods: Retrospective cross-sectional analysis of five years (2016 - 2020) of Indiana's statewide trauma patient registry. Patients under age 15 were included. Those who were transfer patients or missing key data were excluded. In total, 10,926 patients were included in analysis. Baseline years (2016 - 2019) were compared to 2020 to estimate the impact of COVID-19 on pediatric trauma volume.

Results: Overall monthly volume of pediatric traumas were lower than baseline in March and April 2020 (though not significantly), but rebounded quickly and were above trend in the latter half of the year. Injury patterns differed in both mechanism and location from previous years. Gunshot wounds were more prevalent than previous years, while the volume of non-accidental traumas fell slightly. Injuries that occurred in private residences rose significantly, while fewer took place in schools.

Conclusions: Results indicated an initial drop in injury volume consistent with previous findings, but these were offset by increased volume in the second half of 2020. The growth in gun violence is concerning and warrants additional research. Changes in behavior in response to the pandemic such as reduced participation in sports and use of playgrounds, reduced driving, and increased time at home help explain the changes observed in injury patterns. These findings emphasize the continued need for pediatric trauma care during the pandemic.