The impact of the COVID-19 pandemic on pediatric firearm injuries in Colorado

Background: In 2019 firearm injuries surpassed automobile-related injuries as the leading cause of pe-diatric death in Colorado. In the spring of 2020, the COVID-19 pandemic led to community-level social, economic, and health impacts as well as changes to injury epidemiology. Thus, we sought to determine the impact of the COVID-19 pandemic on pediatric firearm injuries in Colorado. Methods: We conducted a retrospective review of pediatric firearm injured patients ( <= 18-years-old) evaluated at three trauma centers in Colorado from 2018-2021. Patients were stratified into two groups based on the time of their firearm injury: pre-COVID injuries and post-COVID injuries. Group differ-ences were examined using t-tests for continuous variables and Chi Squared or Fisher's exact tests for categorical variables. Results: Overall, 343 firearm injuries occurred during the study period. There was a significant increase in firearm injuries as a proportion of overall pediatric ED trauma evaluations following the onset of the COVID-19 pandemic (pre COVID: 5.18/100 trauma evaluations; post COVID: 8.61/100 trauma evaluations, p < 0.0 0 01). Assaults were the most common injury intent seen both pre and post COVID (70.3% vs. 56.7%, respectively); however, unintentional injuries increased significantly from 10.3% to 22.5% ( p = 0.004) fol-lowing the onset of the pandemic. Additionally, the COVID-19 pandemic was associated with a 177% in-crease in unintentional injuries in adolescents. Conclusion: Pediatric firearm injuries, particularly unintentional injuries, increased significantly in Col-orado following the onset of the COVID-19 pandemic. The substantial increase in unintentional injuries among adolescents highlights the necessity of multi-disciplinary approaches to limit or regulate their access to firearms. Level of Evidence: Level III. Study Type: Retrospective.