TY - JOUR
T1 - International Impact of COVID-19 on the Diagnosis of Heart Disease
AU - Einstein, Andrew J
AU - Shaw, Leslee J
AU - Hirschfeld, Cole
AU - Williams, Michelle C
AU - Villines, Todd C
AU - Better, Nathan
AU - Vitola, Joao V
AU - Cerci, Rodrigo
AU - Dorbala, Sharmila
AU - Raggi, Paolo
AU - Choi, Andrew D
AU - Lu, Bin
AU - Sinitsyn, Valentin
AU - Sergienko, Vladimir
AU - Kudo, Takashi
AU - Nørgaard, Bjarne Linde
AU - Maurovich-Horvat, Pál
AU - Campisi, Roxana
AU - Milan, Elisa
AU - Louw, Lizette
AU - Allam, Adel H
AU - Bhatia, Mona
AU - Malkovskiy, Eli
AU - Goebel, Benjamin
AU - Cohen, Yosef
AU - Randazzo, Michael
AU - Narula, Jagat
AU - Pascual, Thomas N B
AU - Pynda, Yaroslav
AU - Dondi, Maurizio
AU - Paez, Diana
AU - The INCAPS COVID Investigators Group
A2 - Kyhl, Kasper
N1 - Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.
PY - 2021/1/19
Y1 - 2021/1/19
N2 - BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified.OBJECTIVES: The study sought to assess COVID-19's impact on global cardiovascular diagnostic procedural volumes and safety practices.METHODS: The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained.RESULTS: Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoracic echocardiography decreased by 59%, transesophageal echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p < 0.001 for each procedure). In multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower-middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth.CONCLUSIONS: COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19-related changes in care delivery is warranted.
AB - BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified.OBJECTIVES: The study sought to assess COVID-19's impact on global cardiovascular diagnostic procedural volumes and safety practices.METHODS: The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained.RESULTS: Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoracic echocardiography decreased by 59%, transesophageal echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p < 0.001 for each procedure). In multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower-middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth.CONCLUSIONS: COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19-related changes in care delivery is warranted.
KW - COVID-19
KW - Diagnostic Techniques, Cardiovascular/statistics & numerical data
KW - Global Health
KW - Health Care Surveys
KW - Heart Diseases/diagnosis
KW - Humans
KW - International Agencies
KW - global health
KW - cardiovascular disease
KW - coronavirus
KW - cardiac testing
UR - http://www.scopus.com/inward/record.url?scp=85098954230&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2020.10.054
DO - 10.1016/j.jacc.2020.10.054
M3 - Journal article
C2 - 33446311
SN - 0735-1097
VL - 77
SP - 173
EP - 185
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 2
ER -