Trauma rates in children in the period of restrictive measures related to the spread of the new coronavirus infection (Covid-19)

Abstract

BACKGROUND: Due to the spread of the novel coronavirus infection (COVID-19) and the introduction of restrictive measures to prevent its spread, there has been a change in the organization and work of medical institutions. New rules for admitting patients with injuries, limiting hospitalization of planned patients, examining patients for coronavirus infection, examining parents of children with injuries, conducting remote consultations, and identifying areas without COVID-19 for repeated outpatient care have been introduced in trauma centers and hospitals. New conditions for the organization and functioning of outpatient and inpatient departments have had an impact on the picture of child trauma. AIM: This study aims to conduct a comparative analysis of the level and nature of musculoskeletal injuries in children who sought medical care during the COVID-19 pandemic and injuries that occurred during the same period of the previous year. MATERIALS AND METHODS: The analysis of the medical history data of 3820 patients aged 0 to 17 years, who were admitted to the City Center for Outpatient Surgery and Trauma of St. Petersburg St. Mary Magdalene Children’s City Hospital No. 2 during the period from March 16, 2020, to May 31, 2020, and for the same period in 2019. RESULTS: The number of initial visits with trauma in 2019 was 2851 patients, whereas during the same period in 2020, 969 patients came with trauma. In general, during the study period in 2020, the trauma rate decreased by 66% compared with the same period in 2019. Despite the general decrease in the level of injuries in the study period in 2020, in the injured structures of the musculoskeletal system, the proportion of limb fractures was 35% and exceeded the same indicator in 2019 (p = 0.004, χ2 criterion). In 2020, the level of street injuries (p < 0.0001) decreased by 83%, while there was a 61% increase in domestic injuries (p < 0.0001) and a 47% increase in traffic injuries (p < 0.0001). CONCLUSION: The relationship between the outbreak of a pandemic and a decrease in the number of visits to the trauma center of Children’s Hospital No. 2 was revealed and a change in the structure of injuries depending on their cause. This change may be associated with restrictive measures, the transfer to distance learning, the ban on organized sports events, and the reduced usage of playgrounds. This information can be useful for planning the work of health authorities and distributing resources during future pandemic situations.