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Impact of COVID-19 on Diagnostic Cardiac Procedural Volume in Oceania: The IAEA Non-Invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID) - 02/09/21

Doi : 10.1016/j.hlc.2021.04.021 
Patricia O’Sullivan, MBBS, FRACP a, John Younger, MBBCh, MRCP, FRACP, FRSANZ b, c, Niels Van Pelt, MBChB d, Sue O’Malley, MBBS e, Dora Lenturut-Katal, MD f, Cole B. Hirschfeld, MD g, Joao V. Vitola, MD, PhD h, Rodrigo Cerci, MD h, Michelle C. Williams, MBChB, PhD i, Leslee J. Shaw, PhD g, j, Paolo Raggi, MD, PhD k, Todd C. Villines, MD l, Sharmila Dorbala, MD, MPH m, Andrew D. Choi, MD n, Yosef Cohen, BA o, Benjamin Goebel, BS g, j, Eli Malkovskiy g, p, Michael Randazzo, MD g, Thomas N.B. Pascual, MD, MHPEd q, Yaroslav Pynda, MSc r, Maurizio Dondi, MD, PhD r, Diana Paez, MD r, Andrew J. Einstein, MD, PhD g, p, s, Nathan Better, MBBS, FRACP a, t, ⁎
on behalf of

the INCAPS COVID Investigators Group

a Royal Melbourne Hospital, Melbourne, Vic, Australia 
b Royal Brisbane Hospital, Brisbane, Qld, Australia 
c University of Queensland, Brisbane, Qld, Australia 
d Middlemore Hospital, Auckland, New Zealand 
e Christchurch Hospital, Christchurch, New Zealand 
f Port Moresby General Hospital, Papua New Guinea 
g Department of Medicine, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, NY, USA 
h Quanta Diagnostico, Curitiba, Brazil 
i BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK 
j Weill Cornell Medical College, New York, NY, USA 
k Department of Medicine and Division of Cardiology, University of Alberta, Edmonton, Canada 
l University of Virginia, Charlottesville, VA, USA 
m Brigham and Women’s Hospital, Boston, WA, USA 
n The George Washington University School of Medicine, Washington, DC, USA 
o Technion Israel Institute of Technology, Haifa, Israel 
p Seymour, Paul and Gloria Milstein Division of Cardiology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, NY, USA 
q Philippines Nuclear Research Institute, Manila, Philippines 
r International Atomic Energy Agency, Vienna, Austria 
s Department of Radiology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, NY, USA 
t University of Melbourne, Melbourne, Vic, Australia 

∗Corresponding author at: Department of Nuclear Medicine, Royal Melbourne Hospital, Grattan St, Parkville, Vic, 3050Department of Nuclear MedicineRoyal Melbourne HospitalGrattan StParkville, Vic3050
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Abstract

Objectives

The INCAPS COVID Oceania study aimed to assess the impact caused by the COVID-19 pandemic on cardiac procedure volume provided in the Oceania region.

Methods

A retrospective survey was performed comparing procedure volumes within March 2019 (pre-COVID-19) with April 2020 (during first wave of COVID-19 pandemic). Sixty-three (63) health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, and 846 facilities outside of Oceania. The percentage change in procedure volume was measured between March 2019 and April 2020, compared by test type and by facility.

Results

In Oceania, the total cardiac diagnostic procedure volume was reduced by 52.2% from March 2019 to April 2020, compared to a reduction of 75.9% seen in the rest of the world (p<0.001). Within Oceania sites, this reduction varied significantly between procedure types, but not between types of health care facility. All procedure types (other than stress cardiac magnetic resonance [CMR] and positron emission tomography [PET]) saw significant reductions in volume over this time period (p<0.001). In Oceania, transthoracic echocardiography (TTE) decreased by 51.6%, transoesophageal echocardiography (TOE) by 74.0%, and stress tests by 65% overall, which was more pronounced for stress electrocardiograph (ECG) (81.8%) and stress echocardiography (76.7%) compared to stress single-photon emission computerised tomography (SPECT) (44.3%). Invasive coronary angiography decreased by 36.7% in Oceania.

Conclusion

A significant reduction in cardiac diagnostic procedure volume was seen across all facility types in Oceania and was likely a function of recommendations from cardiac societies and directives from government to minimise spread of COVID-19 amongst patients and staff. Longer term evaluation is important to assess for negative patient outcomes which may relate to deferral of usual models of care within cardiology.

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Keywords : COVID-19, Coronavirus, Cardiac imaging, Cardiac investigations


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Vol 30 - N° 10

P. 1477-1486 - octobre 2021 Retour au numéro
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