Early exposure: rising assault-related firearm injuries in school-aged children during COVID years

Firearm injuries have become a leading cause of morbidity and mortality among pediatric patients in the United States, with the COVID-19 pandemic exacerbating this alarming trend. However, a knowledge gap persists regarding firearm injury trends and intent by age group. This study analyzes fatal and non-fatal pediatric firearm injuries using data from the Trauma Quality Programs (TQP) Participant Use File (PUF) from 2017 to 2022. Cases were categorized into four age groups: 0–5 years, 6–11 years, 12–14 years, and 15–17 years. Of the 32,931 cases identified, 12,647 occurred pre-COVID (2017–2019), while 20,284 occurred during the COVID period (2020–2022). A significant increase in both injury cases and mortality was observed across all age groups, with adolescents aged 15–17 years holding the largest proportion. Intent of injury varied markedly by age: unintentional injuries predominated in the youngest group, whereas assaults were the leading cause among all other age groups. Notably, assault-related injuries in the 12–14-year-old group surged during the COVID period and remained elevated through 2022, underscoring an urgent need for targeted interventions. These findings highlight critical age-specific differences in firearm injury patterns and emphasize the importance of tailored public health strategies.