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

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.

Myocardial perfusion imaging in the era of COVID-19: a systematic review

“…These surveys included questions about health facilities, medical staff, personal protective equipment, plans for reopening centers damaged by the pandemic, and variations in the number of cardiac imaging procedures—like SPECT MPI—during the COVID-19 pandemic. These online questionnaires did not collect any personal information about the patients [ 44 ]. In addition to reviewing data obtained from facilities, the Data Coordination Committee dealt with mixed, duplicate, and inconsistent data.…”

Oncology and cardiology positron emission tomography/computed tomography faced with COVID-19: A review of available literature data

“…In Oceania, cardiac PET and stress cardiac magnetic resonance (CMR) were the only modalities that did not show a significant reduction between March 2019 and April 2020 May. Cardiac PET has been suggested as an alternative to transesophageal echocardiography for detection of endocarditis in high-risk patients, but the number of examinations did not increase during this period, presumably due to the lack of reimbursement ( 188 ).…”

Heart, Lung and Circulation in the COVID-19 Era: About COVID-19, Not Just About COVID-19

“…2021 has seen further articles about COVID-19 but rather than initial, well-considered pandemic guidance offered by experts and projections and predictions of likely effects to come, we are now seeing original contributions and commentary about the lived experience from the “fields of battle” in Australia and elsewhere in terms of: the acute disease, its manifestations and complications [ [33] , [34] , [35] , [36] , [37] , [38] ]; the adaptations to and opportunities in COVID-19 care [ 39 , 40 ] and in other care settings [ 41 ]; the effects of the COVID-19 pandemic on diagnostic cardiac procedural volumes [ 42 , 43 ] and cardiac surgery [ 44 , 45 ]; and, more recently, the reported side-effects of COVID-19 vaccination [ 46 , 47 ].…”

“…O'Sullivan et al. assessed the early impact caused by the COVID-19 pandemic on cardiac procedure volume in Oceania, finding a significant reduction especially in transoesophageal echocardiography and stress tests [ 42 ]. They say longer term evaluation will be important to assess for negative patient outcomes which may relate to deferral of usual models of care in cardiology.…”