Introduction: Traumatic brain injury (TBI) is a major global health burden and the leading cause of injury-related death and disability worldwide. In March 2020, the World Health Organization (WHO) declared the novel coronavirus disease 2019 (COVID-19) a global pandemic. The purpose of this study was to investigate the effects of the COVID-19 pandemic on the mortality of TBI patients transported by emergency medical services (EMS). Methods: Adult TBI patients who were assessed and transported by EMS between January 2018 and December 2021 were analyzed. The main exposure was the COVID-19 pandemic period at the time of the event. The primary outcome was in-hospital mortality, and the secondary outcome was disability measured using the Glasgow Outcome Scale (GOS), one to three. Multivariable logistic regression analyses were conducted to calculate adjusted odds ratios (aOR) with 95% confidence intervals (95% CIs). Results: A total of 18,988 patients were enrolled for analysis. In-hospital mortality in the COVID-19 era group was 1,812(20.9%), and the non-COVID-19 era group was 2,040 (19.8%). Multivariable logistic regression analysis demonstrated a significantly higher probability of in-hospital mortality in the COVID era group: aOR (95% CIs) 1.11 (1.03-1.20) for the COVID era group. There is no significant difference in disability: aOR (95% CIs) 1.01(0.95-1.08) for the COVID era group. Conclusion: For the TBI patients assessed and transported by EMS in South Korea, subjects transported in the COVID-19 era were more likely to have higher in-hospital mortality compared to non-COVID-19 era. It should be considered when planning and implementing EMS protocols and community healthcare strategies during pandemics.
Yang et al. (Sun,) studied this question.