Impact of the Lockdown Due to COVID-19 Pandemic on the Spectrum and Outcome of Trauma in India

Background: As a pre-emptive measure against the rampaging severe acute respiratory syndrome coronavirus 2 (SARS CoV-2), the Government of India ordered an unprecedented but imperative step of a nationwide lockdown on 22nd March, 2020. The entire month of April 2020 remained in a complete national lockdown. Methodology: We conducted this retrospective study to compare the spectrum and outcome of trauma victims who presented to our emergency department (ED) from April 2020 (lockdown period) to a similar season matched control arm of April 2018 (non-lockdown period). Results: Our study groups included 403 trauma victims (trauma prevalence: 9.7%) from April 2020 as compared to 667 trauma victims (trauma prevalence: 10.8%) from April 2018 with an absolute decrease of -39.6% during the lockdown month. The intense lockdown resulted in an absolute decrease in the number of road traffic accidents (RTA) (-75.1%), sports-related injuries (-81.8%), bull gore injuries (-64.3%), workplace related injuries (-50.0%), and fall from height (-3.5%). However, an absolute increase in the number of falls on level ground (FLG) (+95.7%), domestic trauma (+91.4%), and burn (+37.5%) patients were noted during the lockdown period. The proportion of trauma victims under the influence of alcohol, as determined by a positive blood alcohol content, was significantly lower in the lockdown period (adjusted OR: 0.34 (95% CI: 0.17-0.67); p-value: 0.002) as were RTAs (adjusted OR: 0.44 (95% CI: 0.31-0.62); p-value: <0.001), FLG (adjusted OR: 1.87 (95% CI: 1.14-3.06);-value: 0.0), and head injuries (adjusted OR: 0.21 (95% CI: 0.13-0.3); p-value: <0.001). Conclusion: During the stringent lockdown period of April 2020, there was a significant absolute decrease in the number of trauma victims, especially RTAs. The intense lockdown resulted in a significant decrease in the proportion of trauma victims under the influence of alcohol, head injuries, fractures, and dislocations.