The impact of COVID-19 and associated lockdowns on traumatic spinal cord injury incidence: a population based study

Mccaughey, E. J., Ho, F. K., Mackay, D. F. , Pell, J. P. , Humburg, P. and Purcell, M. (2023) The impact of COVID-19 and associated lockdowns on traumatic spinal cord injury incidence: a population based study. Spinal Cord, (doi: 10.1038/s41393-023-00939-6) (PMID:37919383) (Early Online Publication)

Abstract

Study design Natural experiment Objectives To determine whether COVID-19 restrictions were associated with changes in the incidence of traumatic spinal cord injury (TSCI) in Scotland. Setting The Queen Elizabeth National Spinal Injuries Unit (QENSIU), the sole provider of treatment for TSCI in Scotland. Methods Time series analysis of all admissions for TSCI between 1st January 2015 and 31st August 2022. Results Over the 8-year study period, 745 patients were admitted to the QENSIU with a TSCI. Interrupted time series analysis showed that level 3 and 4 COVID-19 lockdown restrictions (the most severe levels) were associated with lower incidence of TSCI (RR 0.63, CI% CI 0.47, 0.82, p < 0.001). The associations were stronger in people aged over 45 (additive interaction p = 0.001), males (additive interaction p = 0.01) and non-tetraplegia (additive interaction p = 0.002). The incidence of TSCI due to deliberate self-harm was higher (0.41 versus 0.23 per month) during restrictions. Conclusions Overall, TSCI incidence reduced in Scotland when lockdowns were implemented, presumably due to lower engagement in risky activities. The increase in TSCI due to deliberate self-harm may reflect increased mental health problems and social isolation and should be anticipated and targeted in future pandemics. The change in incidence during the COVID-19 pandemic may have an economic impact and see a temporary reduction in the burden on health and social care. The results of this study will be useful for resource planning in future pandemics.

• Item Type: Articles
• Status: Early Online Publication
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Pell, Professor Jill and Mccaughey, Mr Euan and Mackay, Professor Daniel and Ho, Dr Frederick
• Authors: Mccaughey, E. J., Ho, F. K., Mackay, D. F., Pell, J. P., Humburg, P., and Purcell, M.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health; College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience
• Journal Name: Spinal Cord
• Publisher: Springer Nature
• ISSN: 1362-4393
• ISSN (Online): 1476-5624
• Published Online: 02 November 2023
• Copyright Holders: Copyright: © The Author(s) 2023
• First Published: First published in Spinal Cord 2023
• Publisher Policy: Reproduced under a Creative Commons licence