During the COVID-19 pandemic, social distancing and stay-at-home orders have been enacted throughout the world to stop disease transmission and keep people safe. But for those who experience intimate partner violence (IPV), being quarantined with an abuser means that home may be the most dangerous place for a person to be. In recent years, radiologists have been making a concerted effort to help identify injuries associated with IPV. In a new study published in Radiology, a team led by investigators at Brigham and Women's Hospital assessed the incidence, pattern and severity of injuries related to IPV in patients at the Brigham during the spring of 2020. When they compared IPV injuries from 2020 to injuries over the previous three years, they found an alarming increase in physical injuries associated with IPV.
"Despite a decrease in our overall imaging volume, we encountered severe physical injuries related to IPV in the Emergency Department during the COVID-19 pandemic," said the principal investigator and the corresponding author Bharti Khurana, MD, director of Trauma Imaging Research and Innovation Center at the Brigham. "Radiologists and other health care providers should proactively participate in identifying IPV victims and reach out to vulnerable communities as an essential service during the pandemic and other crisis situations."
Khurana and colleagues examined data collected from March 11 to May 3, 2020. They reviewed radiology reports and images and graded them for IPV based on objective signs of abuse. The team developed a grading system based on the location of physical injuries and the depth of injuries. The team then compared injuries seen in the spring of 2020 to data from the same span of time in the previous three years.
The team found 26 cases in which victims sustained physical IPV in the spring of 2020, compared to 20 in 2019, 7 in 2018 and 15 in 2017. The team also looked at the severity of abuse, finding five such cases in 2020 compared to one case each year in the preceding three years. The researchers looked at both superficial and deep injuries, such as injuries from strangulation, stab injuries, burns or use of weapons such as knives, guns and other objects that can cause injury to the deep internal organs. The number of deep injuries during the pandemic was 28 compared to a total of 16 deep injuries during the previous three years.
Overall, a total of 62 IPV victims of all types (physical and non-physical abuse) were identified in 2020; 104 in 2019; 106 in 2018; and 146 in 2017. The larger percentage of severe physical abuse seen during the pandemic may suggest that victims reached out for health care services in later stages of abuse due to fear of COVID-19.
The team's study is retrospective, observational and limited to data from a single institution, thus additional studies are needed to better understand patterns of physical IPV across the U.S. and in other countries during the pandemic.
"Overall, we saw a lower number of IPV victims with a greater number of deep injuries and signs of physical abuse, and this suggests to us that victims may be so fearful of COVID-19 that they aren't reaching us until the abuse is severe," said Khurana. "We know that high-risk physical abuse and severe physical injuries are highly associated with homicide. Even in the middle of a pandemic, we need to recognize the signs of IPV and find opportunities to help patients in need."
Funding for this work was provided by a Stepping Strong Injury Prevention Innovation Award, the Brigham Care Redesign Incubator and Startup Program (BCRISP) and a Mass General Brigham Innovation Discovery Award.
Paper cited: Gosangi, B et al. "Exacerbation of Physical Intimate Partner Violence during the COVID-19 Pandemic" Radiology DOI: 10.1148/radiol.2020202866