Impact of COVID-19 Outbreak on Pediatric Trauma Cases in a Tertiary Trauma Center

Objective: To evaluate the change in the severity, frequency, and characteristics of pediatric trauma patients presented to the emergency department (ED) during the coronavirus disease-2019 (COVID-19) outbreak. Methods: A retrospective corn parative study was conducted in the ED of a tertiary trauma center in Istanbul, Turkey. Trauma patients aged under 18 years who presented to the ED between May 1st and June 30st, 2020 were included. The same dates of the previous year were included as a control group. Comparison of Manchester Triage Scale (MTS), disposition, injury characteristics, the location of the injury, region of injury, and ED length of stay (LOS) was done. Results: 2,779 patients were included. There were a 60% reduction in total ED visits and a 50% reduction in daily ED visits. MTS orange code patients (1.1% vs 1.8%) did not change while MTS green code (69.6% vs 41.8%) decreased significantly. Arrival by ambulance (5.8% vs 11.5%) increased (p<0.001). Penetrating (7.2% vs 27.3%), in-home (48.1% vs 65.1%), and upper limb (27.1 vs 34.4%) injuries increased (p<0.001). Fracture (19.0% vs 14.1%) and blunt trauma (90.7% vs 70.9%) frequency, and fall from ground level (64.5% vs 49.3%) injuries decreased significantly. The ward and intensive care unit (ICU) admissions did not change and ED LOS decreased (p<0.001). Conclusion: We highlighted that there was no change in critical pediatric trauma visits during the COVID-19 pandemic. There is still a need for ward and ICU beds for pediatric trauma patients. The change in injury severity and injury characteristics should be kept in mind while pandemic rearrangements were planned.