Descriptive Epidemiology of Traumatic Injuries During the First Lockdown Period of COVID-19 Crisis in Iran: A Multicenter Study

Abstract

Background: The study of alterations in the epidemiological pattern of traumatic injuries during the COVID-19 crisis can provide estimates in the planning of healthcare resources. In a prospective epidemiological study during the first 45 days of lockdown legislation in Iran and by comparing the results with previously published large population-based studies in Iran, we sought changes in the epidemiology of traumas. Methods: Data were obtained prospectively from the orthopedic emergency departments of two tertiary orthopedic trauma centers in Iran form Feb 20 to Apr 3 2020 for 45 days. Both centers were active in giving care for COVID-19 patients, and they were major referral orthopedic trauma centers. Results: A total of 628 patients with a mean age of 38.9 ± 19.9 (range 1 to 96) years consisting of 640 limb injuries were recruited. There were 387 (60.5%) fractures, 176 (27.5%) lacerations, and only 13 (2%) ligamentous injuries due to sports activities. Low-energy trauma was the most common mechanism of injury (38.3%), and its rate was specifically high as the mechanism of injury among women (69 %). In men, sharp injuries had the highest frequency (33%). Sharp injuries and blunt trauma during labor were 6.6 times and 19.5 times more prevalent in men, respectively. Most injuries were seen in 21 - 40-year-old patients. Distal radius/ulna fracture was the most common site of fracture. There were 233 (36.4%) patients with self-discharge. Conclusions: There were important epidemiological changes during the COVID-19 crisis in trauma patients. The cessation of sports activities resulted in a reduction in ligamentous injuries of sports origin. Women better implemented the stay-at-home strategies shown by a sudden increase in the men to women ratio of risk-taking traumatic injuries. The decreased number of patients with soft-tissue injuries and a high rate of self-discharge must inform the authorities of the fear of in-hospital contamination.