Epidemiological changes in the pattern of children’s traumatic injuries at Hong Kong emergency departments during the COVID-19 pandemic: a retrospective, single-institutional, serial and comparative study
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In brief
In brief
Retrospective study of 725 pediatric trauma cases in Hong Kong reveals that while overall trauma incidence remained stable during COVID-19, the injury pattern shifted significantly toward younger patients with domestic and burn injuries. Road traffic accidents and trauma activations decreased, emphasizing the need for targeted home safety interventions during pandemic restrictions.
- Pediatric trauma incidence remained stable during COVID-19 (5.8 cases/month), but injury patterns shifted significantly toward home-based mechanisms.
- Domestic injuries increased from 65.5% to 85.7% and burns rose from 28% to 45.7% during pandemic lockdowns in Hong Kong children.
- Road traffic accidents decreased significantly (10.6% to 5.7%) with stay-home policies, while trauma severity metrics remained unchanged.
- Younger children (<10 years) comprised a larger proportion of injuries during COVID-19 (85.7% vs 71%), reflecting increased home exposure time.
- No significant increases in self-harm, assault, or abuse were detected, contrasting with concerns about pandemic-related child maltreatment.
Written by the GCMD Library team from the article.
Abstract
Introduction
Trauma is the leading cause of paediatric mortality and morbidity. Stay-home regulations for coronavirus disease 2019 (COVID-19) reportedly changed trauma severity, yet data from Hong Kong were lacking. This study examined Hong Kong’s spectrum of paediatric trauma and addressed knowledge gaps concerning epidemiological changes during COVID-19.
Methods
Children with traumatic injuries who attended a tertiary trauma centre from January 2010 to March 2022 were included in this retrospective, cross-sectional study. We analysed demographic and clinical data and conducted unadjusted bivariate analyses of injury patterns before and after the pandemic.
Results
In total, 725 children attended the Accident and Emergency Department due to trauma, 585 before and 140 during COVID-19. The male-to-female ratio was 1.84:1. The 90-day trauma-related mortality was 0.7%. The overall Injury Severity Score was 3.52 ± 5.95. The paediatric trauma incidence was similar before and after social-distancing policies (both 5.8 cases monthly). Gender, ISS distribution, intensive care unit stay length, and hospital stay length values were similar (p > 0.05). Trauma call activation (8.4% vs. 5.7%, p = 0.002) and road traffic accidents (10.6% vs. 5.7%, p = 0.009) significantly decreased, yet younger-patient injuries (< 10 years old; 85.7% vs. 71%, p < 0.001), burns (28% vs. 45.7%, p < 0.001), and domestic injuries (65.5% vs. 85.7%, p < 0.001) significantly increased. No significant self-harm, assault, or abuse increases were found.
Conclusions
The paediatric trauma incidences were similar before and during the pandemic. However, domestic and burn injuries significantly increased, highlighting the importance of injury prevention.