Effect of the COVID-19 Pandemic on the Epidemiology of Pediatric Traumatic Injury in Brazil

Abstract

Abstract Purpose Globally, governments have implemented measures in response to the COVID-19 pandemic. These measures raised social psychological concerns, causing increased stress among parents and restricted children’s freedom of movement. These factors might led to increased exposure of children to violence, which might result in abusive head trauma. Whether pandemic-related socioeconomic and environmental changes significantly affected the incidence and severity of pediatric traumatic brain injury (TBI) remains unexplored. We aimed to investigate the consequences of the pandemic on the mechanisms and severity of pediatric TBI and related mortality in Brazil. Materials and methods We investigated the patients with TBI aged <18 years who visited a tertiary trauma center in Brazil in 2019 and 2020.The variables included TBI classification, mechanism of trauma, clinical manifestations, need for neurosurgical intervention, and rates of morbidity and mortality. Furthermore, we used a nationwide databank to collect information on mortality from external causes of trauma and violence in the pediatric population both before and during the pandemic. Results Of the patients with traumatic brain injury, 1371 visited the trauma center in 2019 and 1052 in 2020. No difference was noted in the incidence rate of abusive head trauma between these periods (P= 0.142) or in mortality from violence in Brazil. Falls from bicycles significantly increased during the pandemic (P < 0.001). Conclusion In Brazil, rates of abusive head trauma did not increase during the COVID-19 pandemic, but recreational mechanisms of pediatric TBI did increase. A program to educate the population about recreational safety should be implemented.