Patterns of penetrating trauma in New York City before, during, and after the COVID-19 pandemic

PURPOSE: The COVID-19 pandemic profoundly impacted multiple sectors of society, including healthcare. Major cities such as New York City (NYC) saw shifts in injury numbers and patterns during this period, underscoring the need to track these fluctuations to optimize resource allocation, improve trauma protocols, and inform public health policy. We examined trends in penetrating trauma in NYC before, during, and after the COVID-19 pandemic. METHODS: This retrospective cohort study used data from the NYC Health + Hospitals, which includes 11 acute care hospitals and trauma centers citywide. We analyzed electronic medical records from five level I trauma centers and one level II trauma center (pediatric level I) from August 1, 2019, to November 30, 2024. The study included patients with penetrating injuries and excluded minor-mechanism penetrating injuries or those incompatible with stab or gunshot mechanisms. Patients presenting for follow-up of prior injuries were excluded. The study timeframe was divided into three periods: pre-COVID-19 (August 1, 2019-February 29, 2020), COVID-19 (March 1, 2020-December 31, 2021), and post-COVID-19 (January 1, 2022-November 30, 2024). Descriptive statistics were used to summarize demographic and injury characteristics. Proportions are reported as percentages and continuous variables as medians with interquartile ranges (IQRs). RESULTS: Data for 9,118 patients were analyzed. Most were male (87.5%), with a median age of 30 years (IQR, 23-39 years). The incidence of penetrating trauma increased significantly during the COVID-19 period (164 cases per month) compared with pre-COVID-19 (110 cases per month) and post-COVID-19 (136 cases per month). Stab wounds were the most common injury type across all periods (53.7%). CONCLUSIONS: Penetrating trauma cases increased notably during the COVID-19 pandemic in NYC, consistent with nationwide trends. Although not directly measured, socioeconomic stressors such as economic instability, social isolation, and substance abuse are plausible contributors to this increase.