Impact of COVID-19 Shutdown on Neurotrauma Volume in Pennsylvania.

Algattas, Hanna N; McCarthy, David; Kujawski, Brandon; Agarwal, Nitin; Brown, Joshua; Forsythe, Raquel M; Leonardo, Jody; Walsh, Kevin; Gross, Bradley A; Friedlander, Robert M; Okonkwo, David O; Whiting, Donald; Miele, Vincent J

OBJECTIVE The 2020 COVID-19 pandemic resulted in state-specific quarantine protocols and introduced the concept of social distancing into modern parlance. We assess the impact of the COVID-19 pandemic on neurotrauma presentations in the first three months following shutdown throughout Pennsylvania. METHODS The Pennsylvania Trauma Systems Foundation (PTSF) was queried for registry data from the Pennsylvania Trauma Outcomes Study (PTOS) between March 12th and June 5th in each year from 2017 to 2020. RESULTS Following the COVID-19 shutdown, there was a 27% reduction in neurotrauma volume, from 2680 cases in 2017 to 2018 cases in 2020, and a 28.8% reduction in TBI volume. There was no significant difference in neurotrauma phenotype incurred relative to total cases. Injury mechanism was less likely to be motor vehicle collision (MVC) and more likely due to falls, gunshot wound, and recreational vehicle accidents (p<0.05). Location of injury was less likely on roads and public locations and more likely at indoor private locations (p<0.05). The proportion of neurotrauma patients with blood alcohol concentration (BAC) > 0.08 g/dL was reduced in 2020 (11.4% vs 9.0%; p < 0.05). Mortality rate was higher during 2020 compared to pre-COVID years (7.7% vs 6.4%; p<0.05). CONCLUSIONS Statewide shutdown decreased neurotrauma volume and alcohol-related trauma while increasing low-impact traumas and gunshot wounds, with a shift toward injuries occurring in private, indoor locations. Together, these changes increased mortality rate. However, there was not a change in the types of injuries sustained.