Patterns of Traumatic Injury Volume during First Year of COVID-19 Pandemic

Background: Here, we investigate the incidence of traumatic injuries during the COVID-19 pandemic over a year-long period which includes the first documented COVID-19 case in the US as well as rollout of vaccines. The study period includes the months of strictest lockdowns which early reports have focused on, as well as reopening. Methods: This retrospective analysis was performed with all records of trauma patients from our level 1 trauma center’s trauma registry. Mean weekly and total yearly patient counts from 2017–2019 and 2020 were compared using independent samples t-test or Mann-Whitney U test. Shapiro-Wilk and Levene’s tests were used to assess normality and variances, respectively. Results: There were more trauma patients in 2020 than the 2017–2019 average. In 2020, there were significantly higher weekly counts of penetrating injuries vs the 2017–2019 average [mean (SD)] [22.5 (7.2) vs 17.5 (3.1), p < 0.000], specifically gunshot wounds (GSWs) [15.8 (6.0) vs 11.3 (2.7), p < 0.0000] and more assaults [23.3 (6.7) vs 19.4 (3.2), p < 0.0003]. In 2020, fewer falls [11.9 (4.3) vs 13.4 (2.6), p < 0.03], pedestrian/bicycle accidents [5.5 (3.1) vs 7.5 (2.1), p < 0.0002], and accidents in general [45.9 (17.1) vs 50.9 (5.6), p < 0.05] presented to our hospital compared to previous years. Overall, weekly totals were higher than average in 2020, but were lower than average during the strictest shutdowns from March 18 to May 15. Conclusion: During the first 3 months and strictest lockdown of the pandemic, the number of traumatic injuries was significantly lower than average. Once restaurants reopened at 50% capacity, bars reopened, and gatherings of <50 people were allowed, weekly counts of trauma patients were above average in most (26/32, 81%) weeks through the end of the year. Increased GSWs and assaults this year may suggest increased interpersonal conflict. Increased violent and traumatic injury necessitating medical care is concerning for emergency departments and hospitals already overloaded with patient volume and facing staffing shortages due to the COVID-19 pandemic.