Collings, Amelia T.Farazi, ManzurVan Arendonk, KyleFallat, Mary E.Minneci, Peter C.Sato, Thomas T.Speck, K. ElizabethDeans, Katherine J.Falcone, Richard A.Foley, David S.Fraser, Jason D.Keller, Martin S.Kotagal, MeeraLandman, Matthew P.Leys, Charles M.Markel, TroyRubalcava, NathanSt. Peter, Shawn D.Flynn-O’Brien, Katherine T.Midwest Pediatric Surgery Consortium2023-05-092023-05-092022Collings AT, Farazi M, Van Arendonk K, et al. Impact of "Stay-at-Home" orders on non-accidental trauma: A multi-institutional study. J Pediatr Surg. 2022;57(6):1062-1066. doi:10.1016/j.jpedsurg.2022.01.056https://hdl.handle.net/1805/32854This article is made available for unrestricted research re-use and secondary analysis in any form or be any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.Background: It is unclear how Stay-at-Home Orders (SHO) of the COVID-19 pandemic impacted the welfare of children and rates of non-accidental trauma (NAT). We hypothesized that NAT would initially decrease during the SHO as children did not have access to mandatory reporters, and then increase as physicians' offices and schools reopened. Methods: A multicenter study evaluating patients <18 years with ICD-10 Diagnosis and/or External Cause of Injury codes meeting criteria for NAT. "Historical" controls from an averaged period of March-September 2016-2019 were compared to patients injured March-September 2020, after the implementation of SHO ("COVID" cohort). An interrupted time series analysis was utilized to evaluate the effects of SHO implementation. Results: Nine Level I pediatric trauma centers contributed 2064 patients meeting NAT criteria. During initial SHO, NAT rates dropped below what was expected based on historical trends; however, thereafter the rate increased above the expected. The COVID cohort experienced a significant increase in the proportion of NAT patients age ≥5 years, minority children, and least resourced as determined by social vulnerability index (SVI). Conclusions: The COVID-19 pandemic affected the presentation of children with NAT to the hospital. In times of public health crisis, maintaining systems of protection for children remain essential.en-USPublic Health EmergencyPediatric traumaNon-accidental traumaCOVID-19Child abuseArticle