Firearm-related injuries may have increased during COVID-19 pandemic

ANAHEIM, Calif.—Firearm injuries are a leading cause of death in children, and at the beginning of the pandemic, March 2020, there were record-breaking firearm sales. According to research presented during the 2022 American Academy of Pediatrics National Conference & Exhibition, firearm injuries to children increased during the two years of the COVID-19 pandemic.

Authors of the abstract, “Firearm Injury Epidemiology at a Pediatric Level 1 Trauma Center Before and During The COVID-19 Pandemic,” found pediatric firearm-related injuries increased for the two years of the COVID-19 pandemic compared to the prior year. There was also an initial increase in injuries occurring at home where the shooter was a known family member or friend, and the firearm was not properly stored.

“We experienced an increase in pediatric firearm related injuries in spite of a decrease in total pediatric emergency department visits during the COVID-19 pandemic," said senior author Irma T. Ugalde, MD, associate professor and Director of Pediatric Emergency Medicine Research at McGovern Medical School at UTHealth Houston. “These findings parallel the increase in background checks and firearm sales across the nation following the start of the COVID-19 pandemic. A significant increase in firearm injuries occurred in African American children.”

Researchers performed a retrospective review of patient records in a Houston-area hospital from 2019 to 2021, including patient demographics and risk factors of pediatric firearm injuries presenting to the pediatric emergency department. The analysis showed the total number of pediatric firearm-related injury cases increased from 2019 to 2020 and remained elevated in 2021—88 in 2019 compared to 118 in 2020 and 115 in 2021. Firearm related injuries in Black children rose from 30.7% in 2019, 39.8% in 2020, and 47.8%, 2021, and there were increases in patients with mental health illness as well as injuries where the shooter was a known friend.

“Healthcare workers and all who work with children should remain vigilant about screening for potential risk factors for violence and safe storage of firearms,” Dr. Ugalde said.

Dr. Cynthia Orantes, MD, a pediatric emergency medicine fellow at McGovern Medical School, is scheduled to present the study abstract, available below, between 11:30 a.m. to 1 p.m. PT Saturday, Oct. 8, in Room 151 at the Anaheim Convention Center. To request an interview with the authors, journalists may contact Halle E. Jones, at Halle.E.Jones@uth.tmc.edu, or call the 24/7 Media Hotline at 713-500-3030.

Please note: only the abstract is being presented at the meeting. In some cases, the researcher may have more data available to share with media, or may be preparing a longer article for submission to a journal. 

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Program Name: 2022 AAP National Conference & Exhibition

Abstract Title: Firearm Injury Epidemiology at a Pediatric Level 1 Trauma Center Before and During The COVID-19 Pandemic

Houston, TX, United States

Cynthia Orantes, MD,  Hei K. Chan, MS, Daniel Walter, BS,  Summer Chavez, DO, MPH, MPM, Irma T. Ugalde, MD

Firearms are a leading cause of death in children and firearm violence in the United States is a known public health crisis. Record breaking firearm sales and background checks indicating an increase in demand for firearms followed the COVID-19 “stay-at home orders” in March 2020. We aim to describe the changes in pediatric firearm related injuries, demographics, and associated risk factors at a Level 1 trauma center in Houston before and during the COVID 19 pandemic.

We performed a retrospective review examining patient records of a level 1 trauma center in a busy southern metropolitan area from 2019 to 2021. We investigated patient demographics and risk factors of pediatric firearm visits presenting to the Pediatric Emergency Department annually with descriptive statistics. We also examined percent changes in patient characteristics over time using Poisson regression models.

The total number of pediatric firearm related injury cases increased from 2019 to 2020 and remained elevated in 2021 (88 vs 118 vs 115). There was an increase in injuries in African Americans (30.7%, 2019; 39.8%, 2020; 47.8%, 2021) and patients with mental illness (10.2%, 2019; 22.9%, 2020; 14%, 2021) as well as injuries where the shooter was a known friend (5.7%, 2019; 12.7%, 2020; 7.8%, 2021). The injuries occurring at home (22.7%, 2019; 29.7%, 2020; 24.3%, 2021) were more often without adult supervision in 2020 (22.7%, 2019; 30.5%, 2020; 20.0, 2021) and where the firearm was left unlocked (88.9%, 2019; 100%, 2020; 84.6%, 2021).

The total number of pediatric firearm related injuries increased for the two years of the COVID-19 pandemic compared to the prior year. There were more African American patients, patients in single parent households or who had a history of mental illness affected during the pandemic. There was also an initial increase in injuries occurring at home where the shooter was a known family member or friend, and the firearm was not properly stored. Increases in pediatric firearm related injuries in already vulnerable populations should therefore prompt initiatives and future studies to mitigate the risk of injury and death.

Table 1. Clinical Characteristics of Pediatric Firearm Injury Patients

Clinical characteristics of pediatric firearm injuries presenting to pediatric level 1 trauma center.

Table 3. Incident Demographics

Pediatric firearm injury incident demographics