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Neuropediatrics 2023; 54(06): 388-396
DOI: 10.1055/a-2084-2674
Original Article

Trends in Pediatric Mild Traumatic Brain Injury During COVID-19-Related Lockdown—A Single-Center Study

Hanna E. Kläger‡   *
1   Department of Pediatric Neurology and Developmental Medicine, LMU Hospital, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
2   LMU Hospital, Dr. von Hauner Children's Hospital, LMU Center for Children with Medical Complexity, Ludwig-Maximilians-University (LMU), Munich, Germany
,
Benjamin Nast-Kolb‡   *
1   Department of Pediatric Neurology and Developmental Medicine, LMU Hospital, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
2   LMU Hospital, Dr. von Hauner Children's Hospital, LMU Center for Children with Medical Complexity, Ludwig-Maximilians-University (LMU), Munich, Germany
,
Lea Reuter
3   Department of Paediatric Intensive Care and Emergency Medicine, LMU Hospital, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
,
Florian Hoffmann
3   Department of Paediatric Intensive Care and Emergency Medicine, LMU Hospital, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
,
Sabrina Juranek
4   Department of Pediatric Hemostasis and Thrombosis, LMU Hospital, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
,
Christoph Bidlingmaier
4   Department of Pediatric Hemostasis and Thrombosis, LMU Hospital, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
,
Nicole Fabri
1   Department of Pediatric Neurology and Developmental Medicine, LMU Hospital, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
2   LMU Hospital, Dr. von Hauner Children's Hospital, LMU Center for Children with Medical Complexity, Ludwig-Maximilians-University (LMU), Munich, Germany
,
Nils K.T. Schönberg
1   Department of Pediatric Neurology and Developmental Medicine, LMU Hospital, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
2   LMU Hospital, Dr. von Hauner Children's Hospital, LMU Center for Children with Medical Complexity, Ludwig-Maximilians-University (LMU), Munich, Germany
,
Johanna Wagner
1   Department of Pediatric Neurology and Developmental Medicine, LMU Hospital, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
2   LMU Hospital, Dr. von Hauner Children's Hospital, LMU Center for Children with Medical Complexity, Ludwig-Maximilians-University (LMU), Munich, Germany
,
Florian Heinen
1   Department of Pediatric Neurology and Developmental Medicine, LMU Hospital, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
2   LMU Hospital, Dr. von Hauner Children's Hospital, LMU Center for Children with Medical Complexity, Ludwig-Maximilians-University (LMU), Munich, Germany
,
Oliver Muensterer
5   Department of Pediatric Surgery, LMU Hospital, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
,
Christiane Zeller
5   Department of Pediatric Surgery, LMU Hospital, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
,
Anne-Sophie Holler
5   Department of Pediatric Surgery, LMU Hospital, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
,
Alexandra Fröba-Pohl
5   Department of Pediatric Surgery, LMU Hospital, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
,
Michaela V. Bonfert 
1   Department of Pediatric Neurology and Developmental Medicine, LMU Hospital, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
2   LMU Hospital, Dr. von Hauner Children's Hospital, LMU Center for Children with Medical Complexity, Ludwig-Maximilians-University (LMU), Munich, Germany
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Abstract

Background A relevant number of visits to pediatric emergency departments (pED) are associated with mild traumatic brain injury (mTBI). On March 16, 2020, the Bavarian government declared a first full lockdown (LD) related to the coronavirus (COVID-19) pandemic.

Aim The aim of the study was to investigate the impact of LD on pediatric mTBI.

Methods Retrospective chart review of presentations to a pED due to mTBI. Study periods covered LD (03/17/2020 through 05/05/2020) and the same time in 2017, 2018, and 2019 as reference period (RP). Comparative analyses were performed by Chi-square or Fisher's exact test.

Results Numbers of mTBI cases decreased by half. Age distribution did not differ. A significantly higher proportion of mTBI were related to falls at home (p = 0.001). Further, a higher rate of hospital admissions (p = 0.03), a higher proportion of intensive care unit admissions (p = 0.001), a longer duration of hospital stay (p = 0.02), and a higher rate of intracranial pathologies on neuroimaging were observed during LD (p = 0.007).

Conclusion The decrease in mTBI presentations is likely due to an absolute decrease in numbers related to the LD measures, combined with a hesitation to present very minor mTBI to the hospital, because of fear of being infected or not to put additional strain on the healthcare system during this healthcare crisis. On the other hand, data of those that presented with mTBI tend to reflect the more severe spectrum of mTBI.

Keywords

head injury - mechanisms - symptom patterns - neuroimaging - social distancing

* Those authors equally contributed.


Supplementary Material



Publikationsverlauf

Eingereicht: 07. Juni 2022

Angenommen: 12. April 2023

Accepted Manuscript online:
01. Mai 2023

Artikel online veröffentlicht:
26. Juli 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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