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

## TL;DR

This study examines how the COVID-19 pandemic affected hospitalisations and injury patterns in children at a trauma center in 2020 compared to 2019.

## Contribution

The study provides new insights into the impact of pandemic restrictions on pediatric trauma admissions and treatment patterns.

## Key findings

- Hospital admissions decreased by 5.6% and 54.4% during highly restrictive pandemic periods.
- Injuries at home increased, while injuries at school and kindergarten decreased significantly.
- Surgical treatments for wounds and observational treatments for mild brain injuries increased during the pandemic.

## Abstract

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

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.

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.

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.

The online version contains supplementary material available at 10.1007/s00068-024-02453-7.