{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"Research Square"}],"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T11:07:52Z","timestamp":1778497672819,"version":"3.51.4"},"posted":{"date-parts":[[2026,5,11]]},"group-title":"In Review","reference-count":30,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,4,2]]},"abstract":"<title>Abstract<\/title>\n                <p>Study Design:\n Retrospective observational population-based study\nObjective\n Evaluate traumatic spinal cord injury (tSCI) epidemiology before, during, and after the coronavirus disease 2019 (COVID-19) pandemic in Texas\nSetting:\n Texas Department of State Health Services Trauma Database\nMethods\n The trauma database was queried for ICD-10 diagnosis codes pertinent to tSCI (S14, S24, S34, T093, and T91.3) from 2019 to 2024. Outcome measures included tSCI diagnosis, cause of injury, region of tSCI, age, sex, ethnicity, and public health region. A generalized estimating equations (GEE) model was utilized with a binomial distribution to evaluate predictors of injury status (tSCI vs. non-tSCI trauma). Data was evaluated in the pre-pandemic (2019), pandemic (2020-21) and post-pandemic (2022-24) period.\nResults\n A total of 7,901 tSCIs occurred over the study period. Compared with the pandemic period, the pre-pandemic year demonstrated a rate of 1,153 cases per year (OR\u2009=\u20091.96). This rate declined substantially during the pandemic (2020\u20132021) to 468.5 cases per year, followed by a marked rebound in the post-pandemic period (2022\u20132024) to 1,937 cases per year (OR\u2009=\u20093.08). Age, sex, ethnicity, injury mechanism, and Public Health Region were all independently associated with tSCI risk in multivariable GEE models.\nConclusion\n SCI incidence declined during the COVID-19 pandemic, likely due to reduced exposure and healthcare avoidance, and subsequently rebounded markedly in the post-pandemic period, with disproportionate increases observed in Black and Asian groups and overall lower risk in non-PHR 3 regions. These changes in tSCI epidemiology provide critical insight into future research and healthcare priorities.<\/p>","DOI":"10.21203\/rs.3.rs-9304752\/v1","type":"posted-content","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T10:07:38Z","timestamp":1778494058000},"source":"Crossref","is-referenced-by-count":0,"title":["The Influence of the COVID-19 Pandemic on Traumatic Spinal Cord Injury: A Six-Year Population-Based Retrospective Analysis"],"prefix":"10.21203","author":[{"given":"Kelsey","family":"Potter-Baker","sequence":"first","affiliation":[{"name":"University of Texas Rio Grande Valley School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0278-5709","authenticated-orcid":false,"given":"Blake","family":"Martin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maci","family":"Oestreich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0260-0486","authenticated-orcid":false,"given":"Daniel","family":"Salinas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rex","family":"Marco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8400-3177","authenticated-orcid":false,"given":"Ann Van","family":"de Winckel","sequence":"additional","affiliation":[{"name":"usa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/10790268.2023.2260959","article-title":"Health impacts reported in the Spinal Cord Injury COVID-19 Pandemic Experience Survey (SCI-CPES)","author":"Bloom O","year":"2023","unstructured":"Bloom O, Bryce TN, Botticello AL, Galea M, Delgado AD, Dyson-Hudson TA, et al. Health impacts reported in the Spinal Cord Injury COVID-19 Pandemic Experience Survey (SCI-CPES). J Spinal Cord Med. 2023:1\u201310.","journal-title":"J Spinal Cord Med"},{"key":"ref2","author":"Margetis K","unstructured":"Margetis K, Das JM, Emmady PD. Spinal Cord Injuries. StatPearls. Treasure Island (FL)2025."},{"issue":"10","key":"ref3","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.3390\/medicina59101699","article-title":"The impact of COVID-19 on epidemiological features of spinal cord injury in Wuhan, China: a comparative study in different time periods","volume":"59","author":"Altahla R","year":"2023","unstructured":"Altahla R, Alshorman J, Tao X. The impact of COVID-19 on epidemiological features of spinal cord injury in Wuhan, China: a comparative study in different time periods. Medicina. 2023;59(10):1699.","journal-title":"Medicina"},{"issue":"1","key":"ref4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41393-023-00939-6","article-title":"The impact of COVID-19 and associated lockdowns on traumatic spinal cord injury incidence: a population based study","volume":"62","author":"McCaughey EJ","year":"2024","unstructured":"McCaughey EJ, Ho FK, Mackay DF, Pell JP, Humburg P, Purcell M. The impact of COVID-19 and associated lockdowns on traumatic spinal cord injury incidence: a population based study. 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Plos One. 2024;19(2):e0297384.","journal-title":"Plos One"},{"key":"ref6","first-page":"19","article-title":"COVID-19 and Mortality in the Spinal Cord Injury Population: Examining the Impact of Sex, Mental Health, and Injury Etiology","volume":"12","author":"Senthinathan A","year":"2024","unstructured":"Senthinathan A, Tadrous M, Hussain S, Ahmad A, Chu C, Craven BC, et al. COVID-19 and Mortality in the Spinal Cord Injury Population: Examining the Impact of Sex, Mental Health, and Injury Etiology. Healthcare (Basel). 2024;12(19).","journal-title":"Healthcare (Basel)"},{"issue":"1","key":"ref7","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1038\/s41393-022-00868-w","article-title":"Changes in essential care in individuals with spinal cord injury during the COVID-19 pandemic","volume":"61","author":"Draganich C","year":"2023","unstructured":"Draganich C, Philippus A, Eagye KJ, Mikolajczyk B, Morse LR, Monden KR. 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