Table 1.
Shows information on all of the studies included in this systematic review.
| Authors | Department | Statistical Change in Trauma Incidence of Violent Trauma | Study Location | Method of Statistical Assessment | Study Period % (n) | Reference Period % (n) | P value | Study Time Period | COVID-Related Restrictions during Study Period | Duration (Days) | Urban or Rural | Study-specific definition of violence |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Diamond, Lundy, Weber et al. | Hand Surgery | Increase | Philadelphia, Pennsylvania, USA and Irvine, California, USA | Proportion | 47% (n = 16) | 13% (n = 31) | p = 0.001 | March 19 - April 3, 2020 vs. March 11 - March 18, 2020 | Regional Lockdowns: March 19 (Pennsylvania) & March 24 (California) | 15 | Urban | "High risk behaviors:" lawlessness, assault, high-speed vehicular chase |
| Abdallah, Zhao, Kaufman et al. | All | Increase | Philadelphia, Pennsylvania, USA | Proportion | 30.8% (n = 148) | 1.6% (n = 6) | p = 0.006 | February 1 - May 30, 2020 vs. same period 2015–2019 | Regional Lockdown: March 16 | 119 | Urban | Intentional/Violent Trauma |
| Yeung, Brandsma, Karst, et al. | Oral and Maxillofacial Surgery | Not Assessed | London, UK | Proportion | 23.4% (n = 17) | 22.9% (n = 44) | N/A | March 23 - May 3, 2020 vs. same period in 2019 | National Lockdown March 23 | 41 | Urban | Interpersonal Violence |
| Lara-Reyna, Yaeger, Rossitto, et al. | Neurosurgery | Not Assessed | New York, New York, USA | N/A | 12.2% (n = 6) | 9.9% (n = 10) | N/A | March 1 - April 26, 2020 vs. November 1, 2019–February 29, 2020 | Regional Lockdown: March 12 | 56 | Urban | Violence-related injuries |
| Régas, Bellemère, Lamon, et al. | Hand Surgery | Not Assessed | Nantes, France | N/A | 0.9% (n = 175) | N/A | N/A | March 17 - May 10, 2020 | National Lockdown: March 17 | 54 | Urban | Violence-related hand injuries |
| Matthay, Kornblith, Matthay, et al. | All | No Change | San Francisco, California, USA | Rate | Weekly Activations as Mean (SD): Stab Wounds 5.0 (1.9), Blunt Assaults: 3.4 (2.3), GSW 3.1 (1.8) | Weekly Activations as Mean (SD): Stab Wounds 4.6 (2.2), Blunt Assaults: 3.6 (1.8), GSW 2.2 (1.6) | Stab Wounds: p = 0.60, Blunt Assaults: p = 0.79, GSW: p = 0.10 | January 1 - June 30, 2020 vs. same period 2015–2019 | Regional Lockdown: March 17 | 181 | Urban | Assaults and Self-harm |
| Dolci, Marongiu, Leinardi, et al. | Orthopedic and Trauma Surgery Departments | Decrease | Italy, Cagliari | Proportion | 1% (n = 5) | 2% (n = 38) | p = 0.01 | March 10 - May 3, 2020 vs. same period 2019 | National Lockdown: March 9 | 54 | Urban | Aggresssions |
| Pichard, Kopel, Lejeune, et al. | Hand Surgery | No Change | Paris, France | Proportion | 7.2% (n = 18) | 4.5% (n = 33) | p = 0.097 | March 17 - May 10, 2020 vs. same period 2019 | National Lockdown: March 17 | 54 | Urban | Aggresssions |
| Saponaro, Gasparini, Pelo, et al. | Oral and Maxillofacial Surgery | Not Assessed | Rome, Italy | N/A | 18.8% (n = 6) | 16.9% (n = 24) | N/A | March 1 - April 30, 2020 vs. same period 2019 | National Lockdown: March 9 | 60 | Urban | Aggresssions |
| Druel, Andeol, Rongieras, et al. | All | No Change | Lyon, France | Proportion | 3.2% (n = 2) containment period, 4.9% (n = 8) pre-containment | 5.4% (n = 28) | p > 0.05 Pre-containment vs. Containment; p > 0.05 Containment vs. 2019 | March 1 - 16, 2020 (Pre-containment) vs. March 17 - April 17, 2020 (Containment) vs. March 1 - April 17, 2019 | National Lockdown: March 17 | 31 | Urban | Altercations (incl. domestic violence and police-related incidents) |
| Atia, Pocnetz, Selby, et al. | Hand Surgery | Not Assessed | Derby, UK | Proportion | 7.0% (n = 5) | 4.0% (n = 5) | N/A | March 24 - April 17, 2020 vs. April 18 - May 10, 2020 | National Lockdown: March 27 | 24 | Urban | Assault/Punch |
| Hampton, Clark, Baxter, et al. | All | No Change | Rotherham, UK | Proportion | 10.0% (n = 5) | 2019: 14.6% (n = 19), Pre-Lockdown: 19.2% (n = 19) | p > 0.05 | March 10 - 23, 2020 (Pre-Lockdown) vs. March 24-April 7, 2020 (Lockdown) vs. March 24- April 7, 2019 | National Lockdown: March 27 | 13 | Urban | Assault/Punch/Violence |
| MacDonald, Neilly, Davies, et al. | All | No Change | Multiple Sites in Scottland: Glasgow, Aberdeen, Ninewells, Dundee, and Iverness, Scottland | Proportion | 2.5% (n = 33) | 2.8% (n = 48, 2018), 3.4% (n = 61, 2019) | p = 0.15 (2020 vs. 2019); p = 0.62 (2020 vs 2018) | March 23 - May 28, 2020 vs. 2018–2019 | National Lockdown: March 23 | 66 | Urban | Assault/Violence |
| Salzano, Dell'Aversana Orabona, Audino, et al. | Oral and Maxillofacial Surgery | Decrease | 6 Centers in Italy: Naples, Milan, Verona, Catanzaro, Rome, Sassari | Proportion | 13.7% (n = 10) | 22.9% (n = 54) | p = 0.10 | February 23 - May 23, 2020 vs. same period 2019 | National Lockdown: March 9 | 90 | Urban | Assault |
| Harris, Ellis, Gorman, et al. | All | Decrease | Adelaide, Australia | Proportion | 4% (n = 7) | 6% (n = 15) | p = 0.04 | March 23 - May 10, 2020 vs. February 3 - March 22, 2020 | Regional Lockdown: March 23 | 61 | Urban | Assault |
| Rhodes, Petersen, & Biswas | All | No Change | Myrtle Beach, South Carolina, USA | Proportion | 7.28% (n = 57) | 4.95% (n = 50) | p = 0.38 | January 1 - May 1, 2020 vs. same period 2019 | Regional Lockdown: April 8 | 121 | Urban | Assault |
| Jacob, Mwagiru, Thakur, et al. | All | No Change | Sydney, Australia | Rate | Monthly Mean (SD): 17 (2.1) | Monthly Mean (SD): 2016: 20 (2.1), 2017: 16 (4.2), 2018: 17 (4.2), 2019: 13 (2.1) | p > 0.05 | March 1 - April 30, 2020 vs. same period 2016–2019 | National Social Distancing: March 15; National Lockdown: March 29 | 60 | Urban | Assault |
| Fahy, Moore, Kelly, et al. | Radiology | No Change | Dublin, Ireland | Proportion | 3% (n = 4) | 4% (n = 7) | p > 0.05 | March 27 - April 27, 2020 vs. same period 2019 | National Lockdown: March 27 | 31 | Urban | Assault |
| Zsilavecz, Wain, Bruce, et al. | All | No Change | Pietermaritzburg, Kwa-Zulu Natal, South Africa | Proportion | 14.9% (n = 23) | 15.9% (n = 181) | p = 0.68 | March 23 - May 31, 2020 vs. same period in 2015–2019 | National Lockdown: March 23 | 69 | Urban | Assault |
| Vishal, Prakash, Rohit, et al. | Oral and Maxillofacial Surgery | No Change | Ranchi, India | Proportion | 18.6% (n = 11) | 4.1% (n = 9) | p = 0.298 | March 24 - June 30, 2020 vs. same period 2019 | National Lockdown: March 25 | 98 | Urban | Assault |
| Ajayi, Trompeter, Arnander et al. | All | Not Assessed | London, UK | N/A | 5.9% (n = 14) | 7.4% (n = 31) | N/A | March 6 - April 14, 2020 vs. January 26 - March 5, 2020 | National Social Distancing Mandates: March 23 | 40 | Urban | Assault |
| de Boutray, Kün-Darbois, Sigaux, et al. | Oral and Maxillofacial Surgery | Not Assessed | Multiple Sites in France: Paris, Toulouse, Marseille, Nantes, Montepellier, Strasbourg, Amiens, Nice, Perpi, Angers, Nimes, Clermont, Caen | N/A | 39.6% (n = 42) | N/A | N/A | March 16 - April 15, 2020 | National Lockdown: March 16 | 30 | Urban | Assault |
| Gumina, Proietti, Polizzotti, et al. | Orthopedic Surgery | Not Assessed | Italy, Rome | N/A | n = 1 | n = 2 | N/A | March 8 - April 8, 2020 vs. same period 2019 | National Lockdown: March 8 | 31 | Urban | Assault |
| Rathore, Kalia, Gupta, et al. | All | Not Assessed | Mandi, India | N/A | 1.8% (n = 3) | 0% (n = 0) | N/A | March 25 – May 3, 2020 vs. same period 2019 | National Lockdown: March 25 | 39 | Rural | Assault |
| Dhillon, Kumar, Saini, et al. | All | Not Assessed | Chandigarh, India | N/A | 5.0% (n = 5) | 1.4% (n = 5) | N/A | March 25 – May 3, 2020 vs. same period 2019 | National Lockdown: March 25 | 39 | Urban | Assault |
| Bhat & Kamath | All | Not Assessed | Manipal, India | Proportion | 0.42% (n = 1) | 1.5% (n = 9) | N/A | March 22 - May 17, 2020 vs. same period 2019 | National Lockdown: March 25 (Ordered on March 22) | 56 | Rural | Assault |
| Morris, Rogers, Kissmer, et al. | All | Decrease | Pietermaritzburg, Kwa-Zulu Natal, South Africa | Rate | Assault: n = 197; GSW: n = 3 | Assault: 2018: n = 397, 2019: n = 426; GSW: 2018: n = 32 2019: n = 20 | Assault: p < 0.05, GSW: p < 0.05 | April 1 - 30, 2020 vs. same period 2018–2019 | National Lockdown: March 27 | 30 | Urban | Assault/GSW |
| Figueroa, Boddu, Kader, et al. | Neurosurgery | Increase | Miami, Florida, USA | Proportion | 15% | 3% | p = 0.034 | March 1 - April 30, 2020 vs. same period 2016–2019 | Regional Bar/Restaurant Closure: March 17; Regional Lockdown: April 1 | 60 | Urban | Assault/GSW |
| Hashmi, Zahid, Ali, et al. | Orthopedic Surgery | Not Assessed | Karachi, Pakistan | N/A | 6.2% (n = 5) | 3.0% (n = 4) | N/A | March 16 - April 30, 2020 vs. February 1 - March 15, 2020 | National Lockdown: March 15 | 45 | Urban | Assault/GSW |
| Lubbe, Miller, Roehr, et al. | Orthopedic Surgery | Increase | Las Vegas, Nevada, USA | Proportion | GSW: 8.4% (n = 28), Assault: 1.2% (n = 4), Stab Wounds: 0.6% (n = 2) | GSW: 2018: 3.9% (n = 14), 2019: 3.8% (n = 16), Assault: 2018: 2.5% (n = 9), 2019: 3.1% (n = 13), Stab Wounds: 2018: 0% (n = 0), 2019: 0.2% (n = 1) | GSW: p = 0.0008, Assault: p > 0.05, Stab Wounds: p > 0.05 | March 17 - April 30, 2020 vs. same period 2018–2019 | Regional Lockdowns: March 17 | 44 | Urban | Assault/GSW/Stab Wounds |
| Leichtle, Rodas, Procter, et al. | All | No Change | Richmond, Virginia, USA | Proportion | 12.6% (n = 26) | 17.6% (n = 130) | p = 0.09 | March 17 - April 30, 2020 vs. March 1 - 16, 2020 | Regional Lockdown: March 17 | 60 | Urban | Assault/GSW/Stab Wounds |
| Figueiredo, Araújo, Martins et al. | Oral and Maxillofacial Surgery | Not Assessed | Belo Horizonte, Brazil | N/A | 20.4% (n = 11) | 26.1% (n = 23) | N/A | March 24 - 31, 2020 vs. same period 2019 | 1 Week after Regional Lockdown | 7 | Urban | Assault/GSW/Stab Wounds |
| Rajput, Sud, Rees, & Rutka | All | No Change | Liverpool England | Proportion | 17.4% (n = 21) | 16.2% (n = 28) | March 23 - May 10, 2020 vs. January 27 - March 15, 2020 | National Lockdown: March 23 | 48 | Urban | Stab Wounds | Rajput, Sud, Rees, & Rutka |
| Göksoy, Akça, & İnanç | General Surgery | No Change | Istanbul, Turkey | Proportion | 0.7% (n = 2) | 1.4% (n = 5) | p > 0.05 | March 15 - May 15, 2020 vs. same period 2019 | Declaration of study site as a "Pandemic Hospital:" March 15 | 61 | Urban | Firearm Injuries |
| Sherman, Khadra, Kale, et al. | All | Increase | New Orleans, USA | Proportion | 26% (n = 97) | 18% (n = 96) | p = 0.004 | March 20 - May 14, 2020 vs. same period 2019 | Regional Lockdown: March 20 | 55 | Urban | GSW |
| Walker, Heaton, Monroe, et al. | All | No Change | Muliple Locations: Rochester Minnesota, USA; Scottsdale, Arizona, USA; Jacksonville, Florida, USA | Proportion | 0% (n = 0) | 0% (n = 0) | p > 0.99 | Feburary 9 - April 21, 2020 vs. March 17 - April 21, 2019 | Regional Social Distancing: March 17 | 72 | Urban | GSW |
| Kurt NG & Gunes C | All | Not Assessed | Batman, Turkey | N/A | 0% GSWs during the pandemic | N/A | N/A | March 28 - April 28, 2020 vs. same period 2019 | National Social distancing mandates extended on March 28 | 31 | Urban | GSW |
| Murphy, Akehurst, & Mutimer | Orthopedic Surgery | No Change | Gloucester, UK | Rate | Assault: n = 1; Domestic Violence: n = 0 | Assault: 2017: n = 2, 2018: n = 1, 2019: n = 2; Domestic Violence: 2017: n = 0, 2018: n = 1, 2019: n = 0 | p > 0.99 | March 9 - April 26, 2020 vs. same period 2017–2019 | Regional Social Distancing: March 20 | 48 | Urban | Assault/Domestic Violence |
| Gosangi, Park, Thomas, et al. | Radiology | Increase | Boston, Massachusetts, USA | Proportion | 42% (n = 11) | 12% (n = 5) | p < 0.001 | March 11 - May 3, 2020 vs. same period 2017–2019 | Regional Lockdown March 24 | 53 | Urban | Domestic Violence |
| Rhodes, Petersen, Lunsford, & Biswas | All | Increase | Myrtle Beach, South Carolina, USA | Proportion | 1.7% (n = 50) | 1.1% (n = 78) | p < 0.01 | March 16 - April 30, 2020 vs. same period 2019 | Regional School Closures: March 16 | 45 | Urban | Domestic Violence |
| Benazzo, Rossi, Maniscalco, et al. | All | Not Assessed | Italy (15 Unspecified Level 1 or 2 Trauma Centers) | Rate | Weekly rate of domestic violence changes vs. 2019: (Week 1) increased by 15% (2020 n = 595); (Weeks 2–6): decreased by 30% (n = 595), 73% (n = 431), 55% (n = 380), 63% (n = 320), 72% (n = 333) | N/A | N/A | February 23 - April 4, 2020 | National Lockdown: March 9 | 41 | Urban | Domestic Violence |
| Olding, Zisman, Olding, & Fan K | All | Not Assessed | London, UK | N/A | 63.0% (n = 19) | 2018: 89.0% (n = 41), 2019: 96.0% (n = 46) | N/A | March 23 - April 29, 2020 | National Social Distancing Mandates: March 23 | 37 | Urban | Interpersonal violence (including domestic violence) |
| Qasim, Sjoholm, Volgraf, et al. | All | No Change | Philadelphia, PA | Proportion | 17.6% (n = 21) | 13.4% (n = 29) | p = 0.50 | March 9 - April 19, 2020 vs. same period 2019 | Regional Lockdowns: March 19 | 41 | Urban | Pediatric non-accidental trauma |
| Kovler, Ziegfeld, Ryan, et al. | All | Increase | Baltimore, Maryland, USA | Proportion | 13% (n = 8) | 3.6% (n = 7) | p = 0.009 | March 28 - April 27, 2020 vs. same period 2018–2019 | Regional Lockdown: March 27 | 30 | Urban | Physical Child Abuse |