Trauma in Children during Lockdown for SARS-CoV-2 Pandemic. A Brief Report

Influence of COVID-19 pandemic on hospitalisations at a paediatric traumatology department during 2020: a single-centre observational study and comprehensive literature review

PURPOSE

The study investigates changes in the injury characteristics of hospitalised children in a paediatric trauma centre during the COVID-19 pandemic.

METHODS

Data from injured children from the pre-pandemic year 2019 were compared to the pandemic year 2020 using Pearson's chi-squared test and the Mann-Whitney U test. The period of highly restrictive regulations (HRP) was evaluated separately. A comprehensive literature review with defined search terms resulted in a descriptive data synthesis.

RESULTS

Data from 865 patients indicated reductions in admissions of 5.6% and 54.4% during the HRP. In 2020, the hospitalisation time was longer (2.2 ± 2.7 days in 2019 vs. 2.4 ± 2.6 in 2020, p = 0.045); the proportions of wounds requiring surgical therapy (p = 0.008) and of observational treatments, primarily for mild brain injuries (p = 0.046), were higher; and conservative treatments, primarily for contusions, were lower (p = 0.005). There were no significant changes in age, location of lesions, or frequency of surgical therapy; nor were there differences in the HRP, except for fewer injuries in school and kindergarten (p < 0.001). The literature review summarises the main results of 79 studies.

CONCLUSION

Limited resources did not alter the indications for surgical therapy. Further studies should examine whether the more common injuries sustained at home were caused by excessive work/childcare demands on parents. Reduced inpatient conservative treatment implies that hospital resources possibly were overused previously. The literature offers answers to many detailed questions regarding childhood injuries during a pandemic and more efficient safe treatment. Registration Ethical committee of RWTH Aachen University EK 22-320; Center for Translational & Clinical Research RWTH Aachen University (CTC-A) 21-430.

Is It Safe to Stay at Home? Parents’ Perceptions of Child Home Injuries during the COVID-19 Lockdown

The COVID-19 pandemic and stay-at-home regulations have increased child home injuries. This study illustrates the type and frequency of child home injuries in Greece during the COVID-19 lockdown. Moreover, the survey reports the results on parents’ proposals regarding child injuries at home during the COVID-19 quarantine. A community-based, cross-sectional, descriptive study was conducted from November to December 2021 in Greece. Parents were asked to voluntarily complete an anonymous questionnaire, designed for the needs of the research. A statistical analysis of the data was performed using the Kolmogorov–Smirnov and Shapiro–Wilk tests for a normal distribution, a chi-squared (χ²) test to compare percentages among different groups and a non-parametric Mann–Whitney U test to determine the differences in Likert scale variables between two groups. A total of 130 parents with at least one child were questioned through an online questionnaire survey. Of the parents, 39.3%, stated that the number of accidents in their home increased. The most frequent accidents were injuries (49.3%). Most of the accidents occurred inside the house (75.8%) and were observed among children aged 0–4 years. A high percentage of children’s accidents was observed in rural/island areas or in the suburbs. Children who were with either their father or mother had one accident, and a higher number of accidents occurred when the children were with their grandparents, with the nanny or alone. For those parents who had difficulty supervising their child, child accidents increased compared to parents who had the ability to supervise. It was noticed that parents who knew how to provide a safe home stated that the number of accidents remained the same. Parents must organize a safer home. Authorities should educate parents on child injury prevention and provide them with financial facilities to provide a safer house.

Traumatic injuries in children during COVID-19 pandemic: a national report from northern Iran

BACKGROUND

There are no comprehensive and accurate statistics on epidemiology and clinical features, especially during the COVID-19 period. The present study tries to describe the pediatric traumas in a referral treatment center in northern Iran during the COVID-19 period and to compare the available statistics with the years before pandemics to examine the differences in the epidemiology of this event in our country.

METHODS

This cross-sectional study was performed on 543 children under 15 years admitted to this hospital due to different types of traumas in the first six months of 2019 (before the COVID-19 pandemic) and the first six months of 2020 (coinciding with the peak of the pandemic). The information was retrospectively collected by reviewing the hospital recorded files and the trauma-specific hospital information system.

RESULTS

In total, 436 children were referred before the COVID-19 pandemic period and 107 within the pandemic outbreak. The peak age of patients admitted was 2 to 6 years (32.0%) and 70.5% were male. Most of the pointed children had normal weight. The most common mechanism of trauma before and during the COVID-19 pandemic was falling from a height (46.3% versus 42.1%), followed by road accidents (35.6% versus 36.4%). The overall prevalence of penetrating trauma was 6.9% and 9.3%. The most common body sites affected were the head and neck (32.1%) followed by extremities (before the COVID-19 period) and extremities (29.0%) followed by the head and neck (24.3%) (in the COVID-19 period). The overall rates of multiple trauma before and within the pandemic were also 35.6% versus 35.5%. In children aged 12 to 15 years, road accidents were more reported during the COVID-19 pandemic period (68.4% versus 50.9%) and contrarily falling from a height more before the pandemic (25.5% versus 0.0%). In children under two years of age, head and neck trauma was more reported before the COVID-19 period than in the COVID-19 period (55.6% versus 35.5%), while at this age, limb trauma was more common during the COVID-19 period than before (5.6% versus 20.8%) (P = 0.043). In lean children, abdominal and pelvic trauma were mainly seen in the COVID-19 period (28.6% versus 2.6%) (P = 0.035).

CONCLUSION

Referrals of children from traumatic injuries decreased during the COVID-19 period. However, the main differences in the mechanism of trauma and the type and severity of traumatic injuries to children in this period emphasize the provision of specific guidelines for trauma management in children.

Bone Development and Disease in Infants

The aim of this Editorial is to introduce the content of the present Special Issue, entitled "Bone Development and Disease in Infants" [...].