A comparison of child abuse and neglect encounters before and after school closings due to SARS-Cov-2

Background: Risk factors for child abuse and neglect and commonly used reporting mechanisms were highly affected by SARS-Cov-2 pandemic; yet, little is known about the effects of SARS-Cov-2 on rates of child abuse and neglect. Objective: To compare overall rates, demographics, types of abuse and acuity of child abuse and neglect encounters seen at one university health system for the 6 months before and after school closings due to the SARS-Cov-2 pandemic. Participants and setting: Data was extracted from a database of billed ICD10 codes for child abuse and neglect including sexual abuse codes. There were 579 encounters for patients <18 years of age and 476 unique patients. Methods: In addition to ICD10 code and pre/post school closing, each encounter was identified to be inpatient, outpatient and/or emergency department. Demographic data such as age, gender, ethnicity, and race were extracted. Incident rate ratios in addition to descriptive statistics, Mann-Whitney U test, two-sample t-test, or the chi-square test of association were used in the analysis. Results: No significant differences were identified for total rates of child abuse and neglect encounters (p =.08), physical abuse (p =.91) nor child maltreatment (p =.86) codes or in the age (p =.46), gender (p =.58), and race/ethnicity (p =.15) of patient encounters pre- versus post-school closings. The sexual abuse incidence and inpatient encounters increased by 85% (IRR = 1.85, p <.0001; IRR = 1.85, p =.004, respectively). Conclusions: Our findings provide a unique contribution to the existing literature in that we identified a significant increase in the incidence of sexual abuse and higher patient acuity as evidenced by higher rates of inpatient encounters after school closing due to SARS-Cov-2.