How the pandemic spread of COVID-19 affected children's traumatology in Italy: changes of numbers, anatomical locations, and severity.

Abstract

The study aim was to share our experience in hospital reorganization and management of pediatric traumatology in the early stage of COVID-19 pandemic. We centralized pediatric traumatology supposing a reduction of ER admissions, with increased severity of conditions, and a change in fracture patterns; consequently, we reorganized our structure. The COVID-19 epidemic in Europe has seen Italy as the first focus starting from February 21, 2020. Lombardy has been the most affected area. The initial NHS approach determined a high percentage of hospital admissions that led to early overload of hospitals, and we had to reorganize our structure to face the emergency. We retrospectively evaluated the admission and treatment data to observe the epidemiological evolution of pediatric trauma during the lockdown ordinance and compared them with the same period in 2019. We found a reduction of 78% pediatric visits in the ER but no decrease in the number of pediatric fractures. We found a rate of pediatric fractures increased by 21.62%: the upper limb fractures being the most representative. Our expectations were confirmed. We believe that the reorganization and the guidelines by us designed have been effective to spare resources and subtract the pediatric traumatology load from those hospitals dealing with an unexpected number of critical COVID-19 patients. Even if we experienced a significant reduction of pediatric admissions to our trauma ER, the presence of a determined number of fractures justifies the necessity of a specialized hub to collect all pediatric fractures.