Comparison of Trauma and Burn Evaluations in a Pediatric Emergency Department During Pre, Early and Late COVID-19 Pandemic

Background: Pediatric trauma epidemiology altered during early COVID-19 pandemic period but the impact of the ongoing pandemic is unknown. Objectives: To compare pediatric trauma epidemiology between the pre, early and late pandemic periods and to evaluate the association of race and ethnicity on injury severity during the pandemic. Methods: We performed a retrospective study of trauma consults for an injury/burn in children ≤16 years between January 1, 2019 and December 31, 2021. Study period was categorized into pre (January 1, 2019–February 28, 2020), early (March 1, 2020–December 31, 2020), and late (January 1, 2021–December 31, 2021) pandemic. Demographics, etiology, injury/burn severity, interventions and outcomes were noted. Results: A total of 4940 patients underwent trauma evaluation. Compared to pre-pandemic, trauma evaluations for injuries and burns increased during both the early (RR: 2.13, 95% CI: 1.6–2.82 and RR: 2.24, 95% CI: 1.39–3.63, respectively) and late pandemic periods (RR: 1.42, 95% CI: 1.09–1.86 and RR: 2.44, 95% CI: 1.55–3.83, respectively). Severe injuries, hospital admissions, operations and death were higher in the early pandemic but reverted to pre-pandemic levels during late pandemic. Non-Hispanic Blacks had an approximately 40% increase in mean ISS during both pandemic periods though they had lower odds of severe injury during both pandemic periods. Conclusions: Trauma evaluations for injuries and burns increased during the pandemic periods. There was a significant association of race and ethnicity with injury severity which varied with pandemic periods. Level of evidence: Retrospective comparative study, Level III.