ED visits for pediatric injuries decreased during first year of pandemic

Injury-related visits to the emergency department of children’s hospitals decreased by more than a quarter during the first year of the COVID-19 pandemic, according to data published in Pediatrics.

Researchers also found that ED visits related to serious or critical injuries increased across the pandemic, from 15.9% at the beginning to 20.6% by the end.

The authors began the study by observing that the impact of the pandemic on pediatric injuries was “not well described in the literature.”

“As the SARS-CoV-2 pandemic continues to influence public health recommendations for social distancing, an improved understanding of pediatric injury mechanisms, patterns, and severity is needed,” they wrote. “The main aim of this study is to describe the epidemiology of pediatric injury-related visits to children’s hospital EDs in the U.S. during the early and later periods of the SARS-CoV-2 pandemic.”

In a cross-sectional study, the authors used the Pediatric Health Information System database to identify injury-related ED visits at 41 children’s hospitals in the U.S. during the pandemic period, identified by the researchers as March 15, 2020, to March 14, 2021.

They then divided the year into thirds, from early (March 15 to June 30, 2020) to middle (July 1 to Oct. 31, 2020) to late (Nov. 1, 2020, to March 14, 2021). They also used a 3-year comparator period, lasting from March 15, 2017, to March 14, 2020, as control data.

ED-related injury visits decreased by 26.6%, with the largest decline found in minor injuries, as well as superficial injuries and sprains or strains, they found.

Still, there were increases in injuries from firearms compared with the baseline — a 22.9% increase early on, 42.8% increase in the middle period, and 37% increase late. Injuries due to pedal cycles (60.4%, 24.9%, 32.2%) and other transportation (20.8%, 25.3%, 17.9%) also fluctuated, as did suffocation/asphyxiation (21.4%; 20.2%; 28.4%) and injuries due to suicide intent (–16.2%, 19.9%, 21.8%)

“Although visits declined across a broad range of injury types, the proportional increase in injury severity, increases in pedal cyclist, firearm, suffocation/asphyxiation injuries, and injuries due to suicide intent are concerning,” they wrote. “As public health officials continue to urge preparation for ongoing waves of the SARS-CoV-2 pandemic as well as future pandemics, it is of critical importance to prioritize research and develop strategies that promote injury prevention.”