To describe the epidemiology of pediatric injury-related visits to children’s hospital emergency departments (EDs) in the United States (US) during early and later periods of the SARS-CoV-2 pandemic.

Study Design

We conducted a cross-sectional study using the Pediatric Health Information System, an administrative database to identify injury-related ED visits at 41 US children’s hospitals during the SARS-CoV-2 pandemic period (March 15, 2020 to March 14, 2021) and a 3-year comparator period (March 15–March 14, 2017–2020). For these two periods, we compared patient characteristics, injury type and severity, primary discharge diagnoses, and disposition, stratified by early (March 15, 2020 to June 30, 2020), middle (July 1, 2020 to Oct 31, 2020), and late (November 1, 2020 to March 14, 2021) pandemic periods.


Overall, ED injury-related visits decreased by 26.6% during the first year of the SARS-CoV-2 pandemic, with the largest decline observed in minor injuries. ED injury-related visits resulting in serious-critical injuries increased across the pandemic (15.9% early, 4.9% middle, 20.6% late). Injury patterns with the sharpest relative declines included superficial injuries (41.7% early) and sprains/strains (62.4% early). Mechanisms of injury with the greatest relative increases included (1) firearms (22.9% early, 42.8% middle, 37% late); (2) pedal cyclists (60.4%, 24.9%, 32.2%); (3) other transportation (20.8%, 25.3%, 17.9%); and (4) suffocation/asphyxiation (21.4%, 20.2%, 28.4%) and injuries due to suicide intent (-16.2%, 19.9%, 21.8%).


Pediatric injury-related ED visits declined in general. However, there was a relative increase in injuries with the highest severity, which warrants further investigation.

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Competing Interests

CONFLICT OF INTEREST DISCLOSURES: The authors have no conflicts of interest relevant to this article to disclose.