Effect of COVID-19 on pediatric gunshot wounds to the head at a level 1 trauma center.

Background: The United States (US) has one of the highest rates of gunshot-related incidents in the world. Gunshot wounds to the head (GSWH) in the pediatric population are also common, with high morbidity and mortality rates. Methods: We performed a retrospective study to analyze if there was a notable change in trends in pediatric GSWH at our Level 1 Pediatric Trauma Center due to the COVID-19 pandemic. A retrospective study was conducted including patients under the age of 18 presenting with GSWH from January 2014 to May 2023. Variables assessed included demographics, interventions, and outcomes. Data from the county's Child Death Review Team Annual Report on mortality related to gunshot-related deaths from January 2014 to June 2023 were analyzed. Results: In total, thirty-five patients were evaluated at our institution for GSWH. Nineteen patients were treated during the 6 years before the pandemic and sixteen during the 3-year pandemic. Nine patients died at the hospital, with an overall increase during the pandemic. In the county, seventy-two children were killed from gun violence, with 58% (42) from GSWH. Death from GSWH increased in the county cohort during the pandemic. Conclusion: The pandemic affected the outcomes of patients with GSWH at our institution with an overall increase in rates of self-inflicted and drive-by shootings, a doubling of neurosurgical interventions, an increase in acuity of care for long-term disposition, and an increase in mortality. At a county level, there was an increase in overall deaths from GSWHs, the majority of which were nonaccidental.