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

2019年冠状病毒病(COVID-19) 2019-20冠状病毒爆发 严重急性呼吸综合征冠状病毒2型(SARS-CoV-2) 重症监护医学 倍他科诺病毒 心脏病学 心力衰竭 内科学 冠状病毒感染
作者
Andrew J. Einstein,Leslee J. Shaw,Cole B Hirschfeld,Michelle C. Williams,Todd C. Villines,Nathan Better,João V. Vitola,Rodrigo Cerci,Sharmila Dorbala,Paolo Raggi,Andrew D. Choi,Bin Lu,Valentin Sinitsyn,Sergienko Vb,Takashi Kudo,Bjarne L. Nørgaard,Pál Maurovich-Horvat,Roxana Campisi,Elisa Milan,Lizette Louw,Adel H. Allam,Mona Bhatia,Eli Malkovskiy,Benjamin Goebel,Yosef A. Cohen,Michael J. Randazzo,Jagat Narula,Thomas N.B. Pascual,Yaroslav Pynda,Maurizio Dondi,Diana Paez
出处
期刊:Journal of the American College of Cardiology [Elsevier]
卷期号:77 (2): 173-185 被引量:54
标识
DOI:10.1016/j.jacc.2020.10.054
摘要

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.

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