Bicycle injuries presenting to the emergency department during COVID-19 lockdown

Aim: Since the start of the COVID-19 pandemic, there have been many changes in the presenting complaints in paediatric emergency departments (EDs). We sought to characterise the impact of the COVID-19 pandemic on bicycle-related injuries in children presenting to a tertiary care paediatric ED. Methods: We conducted a descriptive, cross-sectional study of ED visits to a large urban tertiary children's hospital, comparing March to October 2020 (the study period) to the same date range 2 years prior (i.e. March to October 2018-2019). We included children 0-17.99 years presenting for a bicycle-related injury. We compared absolute visit counts of bike injuries per month, demographics, triage acuity, injury type and disposition. Results: A total of 1215 bike-related visits were analysed. There were 234 presentations in 2018 (March to October), 305 in 2019, and 676 in 2020. Overall, the mean age was 9.5 years (standard deviation 5.5-13.5), there were 67% males, median Canadian Emergency Department Triage and Acuity Scale score was 3 (interquartile range 3-4) and the most common injuries were fractures (n = 471, 38.8%). There were significantly more bike injuries presenting to the ED per month in the COVID group, 33.7(17.9) versus 84.5(61.4) (two-tailed P value = 0.041). There was no statistical difference in 'severe injuries' pre- versus post-COVID (odds ratio 0.815 (95% confidence interval 0.611-1.088), P = 0.165). Conclusion: There was a significant increase in bicycle-related injuries presenting to our ED during the pandemic, compared to previous years. Evaluating these trends will allow for the exploration of harm reduction strategies for preventing future bicycle-related injuries.