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The ICON Trauma Study: The Impact of the COVID-19 lockdown on Major Trauma workload in the UK

Adiamah, Alfred; Thompson, Amari; Lewis-Lloyd, Christopher; Dickson, Edward; Blackburn, Lauren; Moody, Nick; Gida, Sunil; La Valle, Angelo; Reilly, John-Joe; Saunders, John; Brooks, Adam

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Alfred Adiamah

Amari Thompson

Christopher Lewis-Lloyd

Edward Dickson

Lauren Blackburn

Nick Moody

Sunil Gida

Angelo La Valle

John-Joe Reilly

John Saunders

Adam Brooks


The global pandemic caused by SARS-CoV-2 has impacted population health and care delivery worldwide. As information emerges regarding the impact of “lockdown measures” and changes to clinical practice worldwide; there is no comparative information emerging from the United Kingdom with regard to major trauma.

This observational study from a UK Major Trauma Centre matched a cohort of patients admitted during a 10-week period of the SARS-CoV-2-pandemic (09/03/2020–18/05/2020) to a historical cohort of patients admitted during a similar time period in 2019 (11/03/2019–20/05/2019). Differences in demographics, Clinical Frailty Scale, SARS-CoV-2 status, mechanism of injury and injury severity were compared using Fisher’s exact and Chi-squared tests. Univariable and multivariable logistic regression analyses examined the associated factors that predicted 30-days mortality.

A total of 642 patients were included, with 405 in the 2019 and 237 in the 2020 cohorts, respectively. 4/237(1.69%) of patients in the 2020 cohort tested positive for SARS-CoV-2. There was a 41.5% decrease in the number of trauma admissions in 2020. This cohort was older (median 46 vs 40 years), had more comorbidities and were frail (p [less than] 0.0015). There was a significant difference in mechanism of injury with a decrease in vehicle related trauma, but an increase in falls. There was a twofold increased risk of mortality in the 2020 cohort which in adjusted multivariable models, was explained by injury severity and frailty. A positive SARS-CoV-2 status was not significantly associated with increased mortality when adjusted for other variables.

Patients admitted during the COVID-19 pandemic were older, frailer, more co-morbid and had an associated increased risk of mortality.


Adiamah, A., Thompson, A., Lewis-Lloyd, C., Dickson, E., Blackburn, L., Moody, N., …Brooks, A. (2021). The ICON Trauma Study: The Impact of the COVID-19 lockdown on Major Trauma workload in the UK. European Journal of Trauma and Emergency Surgery, 47, 637–645.

Journal Article Type Article
Acceptance Date Dec 27, 2020
Online Publication Date Feb 9, 2021
Publication Date Jun 1, 2021
Deposit Date Feb 8, 2021
Publicly Available Date Feb 9, 2021
Journal European Journal of Trauma and Emergency Surgery
Print ISSN 1863-9933
Electronic ISSN 1863-9941
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 47
Pages 637–645
Keywords Major trauma; Covid-19; Injury severity; Mortality; ICON-TRAUMA
Public URL
Publisher URL
Additional Information Authors on behalf of The ICON Trauma Study Group.


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