Background As the early peak phase in the coronavirus outbreak has intensified, stay at home mandates were advised requiring individuals to remain home to prevent community transmission of the disease. Further mandates escalated isolated environments such as school closures, social distancing, travel restrictions, closure of public gathering spaces, and business closures. As citizens were forced to stay home during the pandemic, the crisis created unique trends in trauma referrals, which consisted of atypical trends in injuries related to trauma. Methods A retrospective review of all trauma registry patients presenting to a rural American College of Surgeons (ACS) verified Level I trauma center with associated trauma activation before and during the Coronavirus 2019 (COVID-19) pandemic, integral dates January 1, 2020, to May 1, 2020. A comparison was made regarding trauma trends based on the previous year (January 1, 2019, to May 1, 2019). The data collected included patient characteristics, grouping by trauma activation, injury type, injury severity score (ISS), alcohol screen, drug screen, and mode of injury. Results A statistically significant increase was found largely among males (p = 0.02) with positive alcohol screens (p < 0.001). The statistically significant mode of injury among this trauma population included falling, jumping, pushed (p = 0.02); self-harm-jump (p = 0.01); assault (p = 0.03); and assault with sharp object (p = 0.036). Conclusions Although overall trauma volume was reduced preceding and during the COVID-19 stay at home mandates, a significant increase in specific trauma trends were observed, such as falls, jumps, and pushed; self-harm-jumps; assaults; and assaults with sharp objects. Largely, the trauma trends were among men with higher levels of alcohol than previously reported.