Pediatric Dog Bites to the Face May Have Been Less Severe During COVID-19 Pandemic: A Retrospective Cohort Study

Abstract

Pediatric dog bite injuries are one of the most common nonfatal injuries. During COVID-19 pandemic, children stayed at home more than in the past. The effect of pandemic on severity of dog bites to the face in children has not been examined. The objective of this study was to determine the frequency and severity of dog bite injuries to the face in children during the first year of the COVID-19 pandemic when compared to the previous year. A retrospective cohort study was conducted for children with dog bite injuries to the head and neck region who presented to the Emergency Department at Children's Healthcare of Atlanta from March 2019 to March 2021. The predictor variable was the time of injury, and this was divided into pre-lockdown [control group (March 15, 2019, to March 15, 2020), ie pre-L] and lockdown (March 15, 2019, to March 15, 2020), ie post-L. The outcome variable was severity of dog bite defined as one or more of the following: 1) patient required sedation or general anesthesia for repair, 2) 3 or more regions in the head and neck were involved, and/or 3) surgical consultation took place. The investigators used a two-sample t-test, multivariable linear regression models, and modified ANOVA/MANOVA tests to analyze the data (P-value < .05 determined significance). 712 children (370 males) with an average age of 6years old (range, 7months-18years) fit the inclusion criteria. There was a total of 381 cases in the pre-L and 331 in the post-L period. There were more cases on average per month pre-L (31.8 cases/month) than post-L (27.6 cases/month) (P-value=.26). There were 183 pre-L surgical consults compared to 75 post-L (48 vs 22.8% of cases, respectively; P-value ≤ .001). There were 52 pre-L cases that had 3 or more sites in the head and neck compared to 28 during the post-L period (P-value=.032). During the COVID-19 pandemic, there may have been a decrease in the severity of the dog bite injuries. This trend may demonstrate a consequence that is not a direct result of the virus.