COVID-19 pandemic causes drop in cardiovascular diagnostic testing

Diagnosis of heart diseases has abruptly and significantly decreased across the globe due to the coronavirus disease 2019 (COVID-19) pandemic, especially affecting poorer countries, reveals a study.

A worldwide survey was conducted by the International Atomic Energy Agency to examine changes in cardiovascular procedure volumes and safety practices resulting from COVID-19. The investigators obtained noninvasive and invasive cardiac testing volumes from participating sites for March and April 2020 and compared with those from March 2019. They also determined the availability of personal protective equipment (PPE) and changes in pandemic-related testing practice.

A total of 909 inpatient and outpatient centres performing cardiac diagnostic procedures in 108 countries completed the surveys. A 42-percent drop in procedure volumes was seen from March 2019 to March 2020 and 64 percent from March 2019 to April 2020.

Transthoracic echocardiography decreased by 59 percent, transesophageal echocardiography by 76 percent, and stress tests by 78 percent, which varied between stress modalities. In addition, there was a 55-percent reduction in coronary angiography (invasive or computed tomography; p<0.001 for each).

Multivariable regression analysis revealed a significantly greater decrease in procedures performed for centres in countries with lower gross domestic product. Location in a low- and lower–middle-income country correlated with an additional 22-percent reduction in cardiac procedures and less availability of PPE and telehealth.

“Further study of cardiovascular outcomes and COVID-19–related changes in care delivery is warranted,” the investigators said.