Assessing the impact of COVID-19 on hospital admissions in traffic traumas: a systematic review and meta-analysis

Abstract

During the unprecedented COVID-19 lockdowns, road traffic was limited, and a change in the traumatic emergency admission pattern due to road traffic accidents was anticipated afterwards. We conducted the current systematic review and meta-analysis to assess the impact of the COVID-19 pandemic on hospital admissions due to road traffic accidents. Methods: This systematic review and meta-analysis was conducted based on the Joanna Briggs Institute (JBI) instructions. The following databases were searched: PubMed, ISI Web of Knowledge, Scopus, ProQuest, and the Cochrane Library. Two independent reviewers screened articles based on the inclusion criteria for the review and assessed the methodological quality of the included studies using an appropriate appraisal checklist based on the study type, all from JBI. The statistical analysis was performed using CMA software. Considering the heterogeneity among studies, a random effect model was adopted to estimate the pooled effect with 95% CI for binary outcomes. Results: A total of 13 studies were included in this systematic review, and all of them were considered for meta-analysis. According to a meta-analysis, differences in hospital admission rates during the COVID-19 pandemic and one year before this pandemic were statistically significant [RR: 0.685 CI 95% (0.578 -0.813) p<0.00001]. The heterogeneity assessment of the included studies in the meta-analysis showed high heterogeneity (I2=78%, p<0.00001). In addition, the pooled hospital admission rate due to the road traffic crashes before and during the COVID-19 pandemic were [admission rate: 0.192 CI 95% (0.076 - 0.408) p=0.008] and [admission rate: 0.121 CI 95% (0.055 - 0.245) p<0.00001] respectively. The heterogeneity assessment of the included studies in the meta-analysis showed high heterogeneity (I2=78%, p<0.00001). Furthermore, the included studies were evaluated for assessing their publication bias, which showed high dispersion in the distribution of retrieved studies presented in the funnel plot.