Statement of Purpose: The purpose of this study is to epidemiologically describe firearms injuries treated at a Level 1 pediatric trauma center occurring during the COVID-19 pandemic and compare them to injuries seen in the year prior.

Methods: This is a retrospective chart review of patients seen by pediatric trauma surgery for a firearm injury between February 1, 2019 and March 30, 2021; the pre-pandemic time period included February 1, 2019 – March 9, 2020 and the pandemic period included March 10, 2020 – March 31, 2021. We excluded patients with firearms injuries that were not assessed by trauma surgery and patients with injuries from non-powder guns.

Results: Twenty-eight patients were seen for firearm injuries in the pre-pandemic period; 22 (78.5%) were male, and the mean age was 13.3 years, with 17.8% of patients < 10 years old. Sixteen (57.1%) were black, 8 (28.6%) white, and 4 (14.3%) multiracial. The pandemic period included 80 patients with firearm injuries, with 59 (74%) male, and a mean age of 12.5 years. Seventeen (21.5%) were < 10 years old. Fifty-six (70%) of patients during the pandemic period were black, 15 (20%) white, 6 (7.5%) multiracial, and 2 (2.5%) Hispanic. There was no statistically significant difference between the two groups demographically. No patients were identified as having an intentional self-inflicted firearm injury.

Conclusion: While there was a nearly threefold increase in pediatric firearm injuries seen during the pandemic, the demographics of the victims have not changed compared to pre-pandemic patterns. This reflects a need for ongoing and targeted preventive measures to reduce these extremely high-risk injuries.

Key Take Away Points

  • Since the World Health Organization (WHO) declared a pandemic from the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2 or COVID-19), there has been a dramatic increase in the number of pediatric firearm injuries identified when compared to the preceding year.
  • A continued pattern of racial distribution before and during the pandemic with black children being overrepresented in the population with firearm injury as compared to all injuries seen was identified, with an overwhelming majority of firearm injuries occurring in urban areas.
  • The profound escalation of firearm injury in the pediatric population during the pandemic demonstrates the critical need for intensive community intervention and prevention efforts.

Author Biography

Dr. Kristin Garton Crichton is a child abuse pediatrician at Nationwide Children's Hospital where she serves as the clinic medical director for the Child Advocacy Center and the Child Assessment Team Clinic. She is an assistant professor of clinical pediatrics at The Ohio State University. Her clinical interests include child sexual abuse, child physical abuse, and caring for children in foster care; her research interests include many facets of child maltreatment, especially improving early detection of physical abuse. Dr. Farah W. Brink is a child abuse pediatrician at Nationwide Children’s Hospital and Assistant Professor of Clinical Pediatrics at The Ohio State University College of Medicine. She completed her child abuse pediatrics fellowship in 2013 and has been part of the Division of Child and Family Advocacy as an attending physician since that time. Her research interests include all areas of child maltreatment with a focus on physical abuse. Dr. Kelli N. Patterson is a general surgery resident at Ohio State University and a research fellow in the Center for Surgical Outcomes Research at Nationwide Children's Hospital. Nichole L. Michaels, PhD, is a Senior Research Scientist in the Center for Injury Research and Policy at the Abigail Wexner Research Institute at Nationwide Children’s Hospital and an Adjunct Assistant Professor in the Department of Pediatrics at The Ohio State University College of Medicine. Her primary research interests include child maltreatment, substance use disorders, and overdose harm reduction.