How much could a low COVID-19 pandemic change the injury trends? A single-institute, retrospective cohort study

Objectives COVID-19 has changed the epidemiology of trauma. However, Taiwan is a country with a low COVID-19 threat, and people's daily lives have remained mostly unchanged during this period. The purpose of this study is to investigate whether the trend of trauma incidence and the service of trauma care is affected by the relatively minor COVID-19 pandemic in Taiwan. Design A single-institute, retrograde cohort study. Setting An observational study based on the trauma registry of Chang Gung Memorial Hospital (CGMH). Participants Trauma patients presented to the emergency department of CGMH in the period of 1 January to 30 June 2020 (week 1 to week 26) were designated as the COVID-19 group, with 1980 patients in total. Patients of the same period in 2015-2019 were designated as the pre-COVID-19 group, with 10 334 patients overall. Primary and secondary outcome measures The primary outcome is the incidence of trauma admission. Differences in trauma mechanism, severity, location and outcome were also compared in both groups. Results A decrease in trauma incidence during March and April 2020 was noticed. Significant change (p<0.001) in trauma mechanisms was discovered, with decreased burn (5.8% vs 3.6%) and assault (4.8% vs 1.2%), and increased transport accidents (43.2% vs 47.2%) and suicide (0.2% vs 1.0%) in the COVID-19 cohort. A shift in injury locations was also found with a 5% decrement of workplace injuries (19.8% vs 14.8%, p<0.001). Conclusion The limited COVID-19 outbreak in Taiwan has led to a decreased incidence of trauma patients, and the reduction is mostly attributed to the decline in workplace injuries.