Trends in accident-related admissions to pediatric intensive care units during the first COVID-19 lockdown in Germany

  1. Nora Bruns
  2. Lea Willemsen
  3. Katharina Holtkamp
  4. Oliver Kamp
  5. Marcel Dudda
  6. Bernd Kowall
  7. Andreas Stang
  8. Florian Hey
  9. Judith Blankenburg
  10. Sabir Hemmen
  11. Frank Eifinger
  12. Hans Fuchs
  13. Roland Haase
  14. Clemens Andrée
  15. Michael Heldmann
  16. Jenny Potratz
  17. Daniel Kurz
  18. Anja Schumann
  19. Merle Müller-Knapp
  20. Nadine Mand
  21. Claus Doerfel
  22. Peter Dahlem
  23. Tobias Rothoeft
  24. Manuel Ohlert
  25. Katrin Silkenbäumer
  26. Frank Dohle
  27. Fithri Indraswari
  28. Frank Niemann
  29. Peter Jahn
  30. Michael Merker
  31. Nicole Braun
  32. Francisco Brevis Nunez
  33. Matthias Engler
  34. Konrad Heimann
  35. Gerhard Wolf
  36. Dominik Wulf
  37. Claudia Hollborn
  38. Holger Freymann
  39. Nicolas Allgaier
  40. Felix Knirsch
  41. Martin Dercks
  42. Julia Reinhard
  43. Marc Hoppenz
  44. Ursula Felderhoff-Müser
  45. Christian Dohna-Schwake
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Abstract

Objective

To compare the number of accident- and injury-related admissions to pediatric intensive care units (PICU) during the first German COVID-19 lockdown with previous years. To investigate if shifts in types of accidents or injuries occurred, especially regarding non-accidental injuries.

Design

Retrospective observational multicenter study.

Setting

37 German PICUs.

Patients

1444 children and adolescents < 18 years admitted to German PICUs due to trauma or injuries during the first German lockdown period (16.3.-31.5.2020) and during the same periods of the years 2017-2019.

Interventions

None.

Measurements and main results

Standardized morbidity ratios (SMR) and 95% confidence intervals (CI) were calculated for the severity of disease, admission reasons, types of accidents, injury patterns, surgeries and procedures, and outcomes. Disease severity did not differ from previous years. We found an increase in ingestions (SMR 1.41 (CI 0.88 – 2.16)) and a decrease in aspirations (0.77 (0.41 – 1.32)) and burns (0.82 (0.59 – 1.12)). The total number of admissions for trauma remained constant, but traffic accidents (0.76 (0.56 – 1.01) and school/kindergarten accidents (0.25 (0.05 – 0.74) decreased. Household (1.32 (1.05 – 1.64)) and leisure accidents (1.32 (1.05 – 1.65)) increased. Injured structures did not change, but less neurosurgeries (0.69 (0.42 – 1.07)) and more visceral surgeries (2.00 (1.14 – 3.24)) were performed. Non-accidental non-suicidal injuries declined (0.85 (0.50 – 1.37)). Suicide attempts increased in adolescent boys (1.57 (0.58 – 3.42)), while there was a decrease in adolescent girls (0.86 (0.53 – 1.31)).

Conclusions

Our study showed shifts in trauma types and associated surgeries during the lockdown period that are generally in line with current literature. The decreased number of non-accidental non-suicidal injuries we observed does not suggest a fundamental increase in severe child abuse during the lockdown period. The decrease in suicide attempts among adolescent girls confirms previous findings, while the increase among boys has not been described yet and deserves further investigation.

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