Impact of COVID-19 on the imaging diagnosis of cardiac disease in Europe


Michelle Claire Williams, Edinburgh Medical School
Leslee Shaw, Weill Cornell Medical Center
Cole B. Hirschfeld, Columbia University Irving Medical Center
Pal Maurovich-Horvat, Semmelweis Egyetem
Bjarne L. Nørgaard, Aarhus Universitetshospital
Gianluca Pontone, IRCCS Centro Cardiologico Monzino
Amelia Jimenez-Heffernan, Clinica de Coloproctologia Hospital Juan Romon Jimenez
Valentin Sinitsyn, Lomonosov Moscow State University
Vladimir Sergienko, National Medical Research Center of Cardiology, Moscow
Alexey Ansheles, National Medical Research Center of Cardiology, Moscow
Jeroen J. Bax, Leiden University Medical Center - LUMC
Ronny Buechel, UniversitatsSpital Zurich
Elisa Milan, Ospedale Regionale S. Maria dei Battuti
Riemer H.J.A. Slart, Rijksuniversiteit Groningen
Edward Nicol, Royal Brompton Hospital
Chiara Bucciarelli-Ducci, Royal Brompton & Harefield NHS Foundation Trust
Yaroslav Pynda, International Atomic Energy Agency, Vienna
Nathan Better, University of Melbourne
Rodrigo Cerci, Quanta Diagnostico
Sharmila Dorbala, Brigham and Women's Hospital
Paolo Raggi, University of Alberta
Todd C. Villines, Walter Reed National Military Medical Center
Joao Vitola, Quanta Diagnostico
Eli Malkovskiy, Columbia University Irving Medical Center
Benjamin Goebel, Weill Cornell Medicine
Yosef Cohen, Technion - Israel Institute of Technology
Michael Randazzo, Columbia University Irving Medical Center
Thomas N.B. Pascual, Philippine Nuclear Research Institute
Maurizio Dondi, International Atomic Energy Agency, Vienna
Diana Paez, International Atomic Energy Agency, Vienna
Andrew J. Einstein, Columbia University Irving Medical Center
Mohammad Nawaz Nasery
Artan Goda

Document Type


Publication Title

Open Heart


Objectives We aimed to explore the impact of the COVID-19 pandemic on cardiac diagnostic testing and practice and to assess its impact in different regions in Europe. Methods The online survey organised by the International Atomic Energy Agency Division of Human Health collected information on changes in cardiac imaging procedural volumes between March 2019 and March/April 2020. Data were collected from 909 centres in 108 countries. Results Centres in Northern and Southern Europe were more likely to cancel all outpatient activities compared with Western and Eastern Europe. There was a greater reduction in total procedure volumes in Europe compared with the rest of the world in March 2020 (45% vs 41%, p=0.003), with a more marked reduction in Southern Europe (58%), but by April 2020 this was similar in Europe and the rest of the world (69% vs 63%, p=0.261). Regional variations were apparent between imaging modalities, but the largest reductions were in Southern Europe for nearly all modalities. In March 2020, location in Southern Europe was the only independent predictor of the reduction in procedure volume. However, in April 2020, lower gross domestic product and higher COVID-19 deaths were the only independent predictors. Conclusion The first wave of the COVID-19 pandemic had a significant impact on care of patients with cardiac disease, with substantial regional variations in Europe. This has potential long-term implications for patients and plans are required to enable the diagnosis of non-COVID- 19 conditions during the ongoing pandemic.



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