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International Impact of COVID-19 on the Diagnosis of Heart Disease

Publikation: Bidrag til tidsskriftTidsskriftartikelpeer review


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  • Andrew J Einstein
  • Leslee J Shaw
  • Cole Hirschfeld
  • Michelle C Williams
  • Todd C Villines
  • Nathan Better
  • Joao V Vitola
  • Rodrigo Cerci
  • Sharmila Dorbala
  • Paolo Raggi
  • Andrew D Choi
  • Bin Lu
  • Valentin Sinitsyn
  • Vladimir Sergienko
  • Takashi Kudo
  • Bjarne Linde Nørgaard
  • Pál Maurovich-Horvat
  • Roxana Campisi
  • Elisa Milan
  • Lizette Louw
  • Adel H Allam
  • Mona Bhatia
  • Eli Malkovskiy
  • Benjamin Goebel
  • Yosef Cohen
  • Michael Randazzo
  • Jagat Narula
  • Thomas N B Pascual
  • Yaroslav Pynda
  • Maurizio Dondi
  • Diana Paez
  • The INCAPS COVID Investigators Group
  • Kasper Kyhl (Medlem af forfattergruppering)
Vis graf over relationer

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.

TidsskriftJournal of the American College of Cardiology
Udgave nummer2
Sider (fra-til)173-185
Antal sider13
StatusUdgivet - 19 jan. 2021

Bibliografisk note

Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

ID: 73248603