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Decrease Seen in Abusive Head Trauma for Young Children During Pandemic

THURSDAY, April 22, 2021 -- There was a decrease in hospital admissions for children younger than 5 years diagnosed with abusive head trauma (AHT) during the COVID-19 pandemic, according to a study published in the April issue of Pediatrics.

Nathan L. Maassel, M.D., from the Yale University School of Medicine in New Haven, Connecticut, and colleagues compared patient characteristics and mean monthly AHT admissions in 2020 to those from 2017 to 2019 for the period of March 11 to Sept. 30.

The researchers found that 1,317 (0.1 percent) of the 1,216,336 hospitalizations for children younger than 5 years were for AHT. Seven hundred fifty of these occurred during March 11 to September 30, 16 percent of which were in 2020. Children hospitalized with AHT during 2020 had a shorter length of stay compared with those hospitalized in 2017 to 2019, but they were otherwise similar regarding the percentage of intensive care unit stay, ventilator utilization, subdural hemorrhage, retinal hemorrhage, and mortality. When comparing all years together, there was a significant difference seen in mean monthly admissions. Mean monthly admissions were lower in 2020 versus 2019, 2018, and 2017 on pairwise comparisons.

"There is evidence that the incidence of AHT increases during and following an economic recession and following a natural disaster. For these reasons, the observed decrease in hospitalizations for AHT is indeed surprising," write the authors of an accompanying editorial. "Although Maassel et al. conjecture that this decrease may be explained by an increased number of caregivers in the home, there may also be some under-recognition of cases."

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