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UTHealth Houston study finds pediatric firearm injuries increased during the COVID-19 pandemic

Cynthia Orantes, MD, (left) and Irma Ugalde, MD, (right) saw an increase in pediatric firearm-related injuries during the COVID-19 pandemic, despite also seeing a decrease in total pediatric ED visits over the same period. (Photo by Joshua Moffett)
Cynthia Orantes, MD, (left) and Irma Ugalde, MD, (right) saw an increase in pediatric firearm-related injuries during the COVID-19 pandemic, despite also seeing a decrease in total pediatric ED visits over the same period. (Photo by Joshua Moffett)

Researchers at UTHealth Houston saw an increase in pediatric firearm-related injuries during the COVID-19 pandemic, despite also seeing a decrease in total pediatric emergency department (ED) visits over the same period, according to a poster presented at the 2022 American Academy of Pediatrics National Conference & Exhibition in Anaheim, California.

The study, led by Irma Ugalde, MD, associate professor and director of Pediatric Emergency Medicine Research at McGovern Medical School at UTHealth Houston, tracked pediatric patients admitted to a level 1 trauma center in Houston from 2019 through 2021 with firearm-related injuries.  

“While working in the emergency room during the pandemic, we saw a drop in pediatric admissions overall,” said Ugalde, senior author of the study. “But what was really noticeable was that trauma was still very prevalent – in fact probably more so – and we were seeing more firearm injuries.”

At the beginning of the COVID-19 pandemic, there were record-breaking firearm sales and for the first time, firearm injuries were the leading cause of death in children and adolescents, surpassing motor vehicle crashes according to the National Institutes of Health. Ugalde and Cynthia Orantes, MD, a pediatric emergency medicine fellow at McGovern Medical School and lead author of the study, performed a retrospective review of the trauma registry data and patient records.

“We examined our trauma data for the incidence of firearm injuries the year before the pandemic and then the two subsequent years of the pandemic, and we discovered that the number increased significantly,” Ugalde said. 

The analysis showed the total number of pediatric firearm-related injury cases rose from 88 cases in 2019 to 118 cases in 2020 and remained elevated in 2021 with 115 cases. Pediatric firearm-related injuries in Black children rose from 30.7% in 2019, to 39.8% in 2020, to 47.8% in 2021. 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.

In comparison, overall pediatric ED visits decreased by roughly 34.2% from 2019 to 2020 and by 11.8% from 2019 to 2021.

“We also found that mental illness as a risk factor for firearm injuries increased from 10% in 2019 to 23% in 2020,” Ugalde said. “Knowing the risk factors helps us focus our efforts in prevention and finding ways to help mitigate this problem, which is clearly preventable.”

Additional researchers with the Department of Emergency Medicine at McGovern Medical School were Summer Chavez, DO, MPH, MPM; Hei Kit Chan, MS; and Daniel Walter, BS.

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