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

International Impact of COVID-19 on the Diagnosis of Heart Disease / Einstein, Andrew J.; Shaw, Leslee J.; Hirschfeld, Cole; Williams, Michelle C.; Villines, Todd C.; Better, Nathan; Vitola, Joao V.; Cerci, Rodrigo; Dorbala, Sharmila; Raggi, Paolo; Choi, Andrew D.; Lu, Bin; Sinitsyn, Valentin; Sergienko, Vladimir; Kudo, Takashi; Linde N(\o)rgaard, Bjarne; Maurovich-Horvat, P('(a))l; Campisi, Roxana; Milan, Elisa; Louw, Lizette; Allam, Adel H.; Bhatia, Mona; Malkovskiy, Eli; Goebel, Benjamin; Cohen, Yosef; Randazzo, Michael; Narula, Jagat; Pascual, Thomas N. B.; Pynda, Yaroslav; Dondi, Maurizio; Paez, Diana; Hinterleitner, Gerd; Lu, Yao; Morozova, Olga; Xu, Zhuoran; Lopez-Mattei, Juan; Parwani, Purvi; Nawaz Nasery, Mohammad; Goda, Artan; Shirka, Ervina; Benlabgaa, Rabie; Bouyoucef, Salah; Medjahedi, Abdelkader; Nailli, Qais; Agolti, Mariela; Nicolas Aguero, Roberto; del Carmen Alak, Maria; Graciela Alberguina, Lucia; Arro(\~(n))ada, Guillermo; Astesiano, Andrea; Astesiano, Alfredo; Bas Norton, Carolina; Benteo, Pablo; Blanco, Juan; Manuel Bonelli, Juan; Javier Bustos, Jose; Cabrejas, Raul; Cachero, Jorge; Canderoli, Alejandro; Carames, Silvia; Carrascosa, Patr('(\i))cia; Castro, Ricardo; Cendoya, Oscar; Martin Cognigni, Luciano; Collaud, Carlos; Cortes, Claudia; Courtis, Javier; Cragnolino, Daniel; Daicz, Mariana; De La Vega, Alejandro; Teresa De Maria, Silvia; Del Riego, Horacio; Dettori, Fernando; Deviggiano, Alejandro; Dragonetti, Laura; Embon, Mario; Emilio Enriquez, Ruben; Ensinas, Jorge; Faccio, Fernando; Facello, Adolfo; Garofalo, Diego; Geronazzo, Ricardo; Gonza, Natalia; Gutierrez, Lucas; Angel Guzzo, Miguel; Hasbani, Victor; Huerin, Melina; Jäger, Victor; Manuel Lewkowicz, Julio; L('(o))pez De Muna('(\i))n, Maria Nieves A.; Maria Lotti, Jose; Marquez, Alejandra; Masoli, Osvaldo; Mastrovito, Edgardo; Mayoraz, Matias; Eva Melado, Graciela; Mele, Anibal; Fernanda Merani, Maria; Horacio Meretta, Alejandro; Molteni, Susana; Montecinos, Marcos; Noguera, Eduardo; Novoa, Carlos; Pereyra Sueldo, Claudio; Perez Ascani, Sebastian; Pollono, Pablo; Paula Pujol, Maria; Radzinschi, Alejandro; Raimondi, Gustavo; Redruello, Marcela; Rodr('(\i))guez, Marina; Rodr('(\i))guez, Mat('(\i))as; Lorena Romero, Romina; Romero Acu(\~(n))a, Arturo; Rovaletti, Federico; San Miguel, Lucas; Solari, Lucrecia; Strada, Bruno; Traverso, Sonia; Simona Traverzo, Sonia; del Huerto Velazquez Espeche, Maria; Sebastian Weihmuller, Juan; Wolcan, Juan; Zeffiro, Susana; Sakanyan, Mari; Beuzeville, Scott; Boktor, Raef; Butler, Patrick; Calcott, Jennifer; Carr, Loretta; Chan, Virgil; Chao, Charles; Chong, Woon; Dobson, Mark; extquotesingle)Arne Downie, D(; Dwivedi, Girish; Elison, Barry; Engela, Jean; Francis, Roslyn; Gaikwad, Anand; Gangasandra Basavaraj, Ashok; Goodwin, Bruce; Greenough, Robert; Hamilton-Craig, Christian; Hsieh, Victar; Joshi, Subodh; Lederer, Karin; Lee, Kenneth; Lee, Joseph; Magnussen, John; Mai, Nghi; Mander, Gordon; Murton, Fiona; Nandurkar, Dee; Neill, Johanne; O( extquotesingle)Rourke, Edward; O( extquotesingle)Sullivan, Patricia; Pandos, George; Pathmaraj, Kunthi; Pitman, Alexander; Poulter, Rohan; Premaratne, Manuja; Prior, David; Ridley, Lloyd; Rutherford, Natalie; Salehi, Hamid; Saunders, Connor; Scarlett, Luke; Seneviratne, Sujith; Shetty, Deepa; Shrestha, Ganesh; Shulman, Jonathan; Solanki, Vijay; Stanton, Tony; Stuart, Murch; Stubbs, Michael; Swainson, Ian; Taubman, Kim; Taylor, Andrew; Thomas, Paul; Unger, Steven; Upton, Anthony; Vamadevan, Shankar; Van Gaal, William; Verjans, Johan; Voutnis, Demetrius; Wayne, Victor; Wilson, Peter; Wong, David; Wong, Kirby; Younger, John; Feuchtner, Gudrun; Mirzaei, Siroos; Weiss, Konrad; Maroz-Vadalazhskaya, Natallia; Gheysens, Olivier; Homans, Filip; Moreno-Reyes, Rodrigo; Pasquet, Agn(\`(e))s; Roelants, Veronique; Van De Heyning, Caroline M.; Araujo R('(\i))os, Ra('(u))l; Soldat-Stankovic, Valentina; Stankovic, Sinisa; Helena Albernaz Siqueira, Maria; Almeida, Augusto; Henrique Alves Togni, Paulo; Henrique Andrade, Jose; Andrade, Luciana; Anselmi, Carlos; Ara('(u))jo, Roberta; Azevedo, Guilherme; Bezerra, Sabbrina; Biancardi, Rodrigo; Blacher Grossman, Gabriel; Brand(\~(a))o, Simone; Bromfman Pianta, Diego; Carreira, Lara; Castro, Bruno; Chang, Tien; Cunali, Fernando; Cury, Roberto; Dantas, Roberto; de Amorim Fernandes, Fernando; De Lorenzo, Andrea; De Macedo Filho, Robson; Erthal, Fernanda; Fernandes, Fabio; Fernandes, Juliano; Ferreira De Souza, Thiago; Furlan Alves, Wilson; Ghini, Bruno; Goncalves, Luiz; Gottlieb, Ilan; Hadlich, Marcelo; Kameoka, Vin('(\i))cius; Lima, Ronaldo; Lima, Adna; Willain Lopes, Rafael; e Silva, Ricardo Machado; Magalh(\~(a))es, Tiago; Martins Silva, F('(a))bio; Eduardo Mastrocola, Luiz; Medeiros, F('(a))bio; Claudio Meneghetti, Jos('(e)); Naue, Vania; Naves, Danilo; Nolasco, Roberto; Nomura, Cesar; Bruno Oliveira, Joao; Paixao, Eduardo; Penna De Carvalho, Filipe; Pinto, Ibraim; Possetti, Priscila; Quinta, Mayra; Rizzo Nogueira Ramos, Rodrigo; Rocha, Ricardo; Rodrigues, Alfredo; Rodrigues, Carlos; Romantini, Leila; Sanches, Adelina; Santana, Sara; Sara da Silva, Leonardo; Schvartzman, Paulo; Sebasti(\~(a))o Matushita, Cristina; Senra, Tiago; Shiozaki, Afonso; Eduarda Menezes de Siqueira, Maria; Siqueira, Cristiano; Smanio, Paola; Eduardo Soares, Carlos; Soares Junior, Jos('(e)); Sommer Bittencourt, Marcio; Spiro, Bernardo; Tinoco Mesquita, Cl('(a))udio; Torreao, Jorge; Torres, Rafael; Uellendahl, Marly; Urpia Monte, Guilherme; Ver('(\i))ssimo, Ot('(a))via; Vieira Cabeda, Estevan; Villela Pedras, Felipe; Waltrick, Roberto; Zapparoli, Marcello; Naseer, Hamid; Garcheva-Tsacheva, Marina; Kostadinova, Irena; Theng, Youdaline; Abikhzer, Gad; Barette, Rene; Chow, Benjamin; Dabreo, Dominique; Friedrich, Matthias; Garg, Ria; Nassoh Hafez, Mohammed; Johnson, Chris; Kiess, Marla; Leipsic, Jonathon; Leung, Eugene; Miller, Robert; Oikonomou, Anastasia; Probst, Stephan; Roifman, Idan; Small, Gary; Tandon, Vikas; Trivedi, Adwait; White, James; Zukotynski, Katherine; Canessa, Jose; Castro Mu(\~(n))oz, Gabriel; Concha, Carmen; Hidalgo, Pablo; Lovera, Cesar; Massardo, Teresa; Salazar Vargas, Luis; Abad, Pedro; Arturo, Harold; Ayala, Sandra; Benitez, Luis; Cadena, Alberto; Caicedo, Carlos; Calder('(o))n Moncayo, Antonio; Gomez, Sharon; Gutierrez Villamil, Claudia T.; Jaimes, Claudia; Luis Londo(\~(n))o Blair, Juan; Pabon, Luz; Pineda, Mauricio; Carlos Rojas, Juan; Ruiz, Diego; Valencia Escobar, Manuel; Vasquez, Andres; Vergel, Damiana; Zuluaga, Alejandro; Berrocal Gamboa, Isabel; Castro, Gabriel; Gonz('(a))lez, Ulises; Baric, Ana; Batinic, Tonci; Franceschi, Maja; Hrabak Paar, Maja; Jukic, Mladen; Medakovic, Petar; Persic, Viktor; Prpic, Marina; Punda, Ante; Felipe Batista, Juan; Manuel G('(o))mez Lauchy, Juan; Marcos Gutierrez, Yamile; Marcos Gutierrez, Yamile; Men('(e))ndez, Rayner; Peix, Amalia; Rochela, Luis; Panagidis, Christoforos; Petrou, Ioannis; Engelmann, Vaclav; Kaminek, Milan; Kincl, Vladim('(\i))r; Lang, Otto; Simanek, Milan; Abdulla, Jawdat; B(\o)ttcher, Morten; Christensen, Mette; Christian Gormsen, Lars; Hasbak, Philip; Hess, S(\o)ren; Holdgaard, Paw; Johansen, Allan; Kyhl, Kasper; Altern (\O)vrehus, Kristian; Peter R(\o)nnow Sand, Niels; Steffensen, Rolf; Thomassen, Anders; Zerahn, Bo; Perez, Alfredo; Alejandro Escorza Velez, Giovanni; Sanchez Velez, Mayra; Shawky Abdel Aziz, Islam; Abougabal, Mahasen; Ahmed, Taghreed; Asfour, Ahmed; Hassan, Mona; Hassan, Alia; Ibrahim, Ahmed; Kaffas, Sameh; Kandeel, Ahmed; Mandour Ali, Mohamed; Mansy, Ahmad; Maurice, Hany; Nabil, Sherif; Shaaban, Mahmoud; Camila Flores, Ana; Poksi, Anne; Knuuti, Juhani; Kokkonen, Velipekka; Larikka, Martti; Uusitalo, Valtteri; Bailly, Matthieu; Burg, Samuel; Deux, Jean-Fran(\c(c))ois; Habouzit, Vincent; Hyafil, Fabien; Lairez, Olivier; Proffit, Franck; Regaieg, Hamza; Sarda-Mantel, Laure; Tacher, Vania; Schneider, Roman P.; Ayetey, Harold; Angelidis, George; Archontaki, Aikaterini; Chatziioannou, Sofia; Datseris, Ioannis; Fragkaki, Christina; Georgoulias, Panagiotis; Koukouraki, Sophia; Koutelou, Maria; Kyrozi, Eleni; Repasos, Evangelos; Stavrou, Petros; Valsamaki, Pipitsa; Gonzalez, Carla; Gutierrez, Goleat; Maldonado, Alejandro; Buga, Klara; Garai, Ildiko; Schmidt, Erzs('(e))bet; Szilveszter, Balint; V('(a))rady, Edit; Banthia, Nilesh; Kumar Bhagat, Jinendra; Bhargava, Rishi; Bhat, Vivek; Choudhury, Partha; Sai Chowdekar, Vijay; Irodi, Aparna; Jain, Shashank; Joseph, Elizabeth; Kumar, Sukriti; Mahapatra, Girijanandan; Mitra, Deepanjan; Rai Mittal, Bhagwant; Ozair, Ahmad; Patel, Chetan; Patel, Tapan; Patel, Ravi; Patel, Shivani; Saxena, Sudhir; Sengupta, Shantanu; Singh, Santosh; Singh, Bhanupriya; Sood, Ashwani; Verma, Atul; Affandi, Erwin; Savenadia Alam, Padma; Edison, Edison; Gunawan, Gani; Hapkido, Habusari; Hidayat, Basuki; Huda, Aulia; Praja Mukti, Anggoro; Prawiro, Djoko; Affandi Soeriadi, Erwin; Syawaluddin, Hilman; Albadr, Amjed; Assadi, Majid; Emami, Farshad; Houshmand, Golnaz; Maleki, Majid; Tajik Rostami, Maryam; Rasoul Zakavi, Seyed; Abu Zaid, Eed; Agranovich, Svetlana; Arnson, Yoav; Bar-Shalom, Rachel; Frenkel, Alex; Knafo, Galit; Lugassi, Rachel; Shlomo Maor Moalem, Israel; Mor, Maya; Muskal, Noam; Ranser, Sara; Shalev, Aryeh; Albano, Domenico; Alongi, Pierpaolo; Arnone, Gaspare; Bagatin, Elisa; Baldari, Sergio; Bauckneht, Matteo; Bertelli, Paolo; Bianco, Francesco; Bonfiglioli, Rachele; Boni, Roberto; Bruno, Andrea; Bruno, Isabella; Busnardo, Elena; Califaretti, Elena; Camoni, Luca; Carnevale, Aldo; Casoni, Roberta; Ugo Cavallo, Armando; Cavenaghi, Giorgio; Chierichetti, Franca; Chiocchi, Marcello; Cittanti, Corrado; Colletta, Mauro; Conti, Umberto; Cossu, Alberto; Cuocolo, Alberto; Cuzzocrea, Marco; Luisa De Rimini, Maria; De Vincentis, Giuseppe; Del Giudice, Eleonora; Del Torto, Alberico; Della Tommasina, Veronica; Durmo, Rexhep; Anna Erba, Paola; Evangelista, Laura; Faletti, Riccardo; Faragasso, Evelina; Farsad, Mohsen; Ferro, Paola; Florimonte, Luigia; Frantellizzi, Viviana; Massimo Fringuelli, Fabio; Gatti, Marco; Gaudiano, Angela; Gimelli, Alessia; Giubbini, Raffaele; Giuffrida, Francesca; Ialuna, Salvatore; Laudicella, Riccardo; Leccisotti, Lucia; Leva, Lucia; Liga, Riccardo; Liguori, Carlo; Longo, Giampiero; Maffione, Margherita; Elisabetta Mancini, Maria; Marcassa, Claudio; Nardi, Barbara; Pacella, Sara; Pepe, Giovanna; Pontone, Gianluca; Pulizzi, Sabina; Quartuccio, Natale; Rampin, Lucia; Ricci, Fabrizio; Rossini, Pierluigi; Rubini, Giuseppe; Russo, Vincenzo; Mauro Sacchetti, Gian; Sambuceti, Gianmario; Scarano, Massimo; Sciagr(\`(a)), Roberto; Sperandio, Massimiliano; Stefanelli, Antonella; Ventroni, Guido; Zoboli, Stefania; Baugh, Dainia; Chambers, Duane; Madu, Ernest; Nunura, Felix; Asano, Hiroshi; Misato Chimura, Chimura; Fujimoto, Shinichiro; Fujisue, Koichiro; Fukunaga, Tomohisa; Fukushima, Yoshimitsu; Fukuyama, Kae; Hashimoto, Jun; Ichikawa, Yasutaka; Iguchi, Nobuo; Imai, Masamichi; Inaki, Anri; Ishimura, Hayato; Isobe, Satoshi; Kadokami, Toshiaki; Kato, Takao; Kumita, Shinichiro; Maruno, Hirotaka; Mataki, Hiroyuki; Miyagawa, Masao; Morimoto, Ryota; Moroi, Masao; Nagamachi, Shigeki; Nakajima, Kenichi; Nakata, Tomoaki; Nakazato, Ryo; Nanasato, Mamoru; Naya, Masanao; Norikane, Takashi; Ohta, Yasutoshi; Okayama, Satoshi; Okizaki, Atsutaka; Otomi, Yoichi; Otsuka, Hideki; Saito, Masaki; Yasushi Sakata, Sakata; Sarai, Masayoshi; Sato, Daisuke; Shiraishi, Shinya; Suwa, Yoshinobu; Takanami, Kentaro; Takehana, Kazuya; Taki, Junichi; Tamaki, Nagara; Taniguchi, Yasuyo; Teragawa, Hiroki; Tomizawa, Nobuo; Tsujita, Kenichi; Umeji, Kyoko; Wakabayashi, Yasushi; Yamada, Shinichiro; Yamazaki, Shinya; Yoneyama, Tatsuya; Rawashdeh, Mohammad; Batyrkhanov, Daultai; Dautov, Tairkhan; Makhdomi, Khalid; Ombati, Kevin; Alkandari, Faridah; Garashi, Masoud; Lim Coie, Tchoyoson; Rajvong, Sonexay; Kalinin, Artem; Kalnina, Marika; Haidar, Mohamad; Komiagiene, Renata; Kviecinskiene, Giedre; Mataciunas, Mindaugas; Vajauskas, Donatas; Picard, Christian; Karim, Noor Khairiah A.; Reichmuth, Luise; Samuel, Anthony; Aaftaab Allarakha, Mohammad; Shantaram Naojee, Ambedhkar; Alexanderson-Rosas, Erick; Barragan, Erika; Becerril Gonz('(a))lez-Montecinos, Alejandro; Cabada, Manuel; Calderon Rodriguez, Daniel; Carvajal-Juarez, Isabel; Cort('(e))s, Violeta; Cort('(e))s, Filiberto; De La Pe(\~(n))a, Erasmo; Gama-Moreno, Manlio; Gonz('(a))lez, Luis; Gonzalez Ram('(\i))rez, Nelsy; Jim('(e))nez-Santos, Mois('(e))s; Matos, Luis; Monroy, Edgar; Morelos, Martha; Ornelas, Mario; Alberto Ortga Ramirez, Jose; Preciado-Anaya ('(O))scar Ulises Preciado-Guti('(e))rrez, Andr('(e))s; Puente Barragan, Adriana; Graciela Rosales Uvera, Sandra; Sandoval, Sigelinda; Santaularia Tomas, Miguel; Sierra-Galan, Lilia M.; Siu, Silvia; Vallejo, Enrique; Valles, Mario; Faraggi, Marc; Sereegotov, Erdenechimeg; Ilic, Srdja; Ben-Rais, Nozha; Ismaili Alaoui, Nadia; Taleb, Sara; Pa Pa Myo, Khin; Si Thu, Phyo; Kumar Ghimire, Ram; Rajbanshi, Bijoy; Barneveld, Peter; Glaudemans, Andor; Habets, Jesse; Pieter Koopmans, Klaas; Manders, Jeroen; Pool, Stefan; Scholte, Arthur; Scholtens, Asbj(\o)rn; Slart, Riemer; Thimister, Paul; Van Asperen, Erik-Jan; Veltman, Niels; Verschure, Derk; Wagenaar, Nils; Edmond, John; Ellis, Chris; Johnson, Kerryanne; Keenan, Ross; Hua (Anthony) Kueh, Shaw; Occleshaw, Christopher; Sasse, Alexander; To, Andrew; Van Pelt, Niels; Young, Calum; Cuadra, Teresa; Bladimir Roque Vanegas, Hector; Adamou Soli, Idrissa; Moussa Issoufou, Djibrillou; Ayodele, Tolulope; Madu, Chibuzo; Onimode, Yetunde; Efros-Monsen, Elen; Helene Forsdahl, Signe; Hildre Dimmen, Jenni-Mari; J(\o)rgensen, Arve; Krohn, Isabel; L(\o)vhaugen, P(\aa)l; Tjellaug Br(\aa)ten, Anders; Al Dhuhli, Humoud; Al Kindi, Faiza; Al-Bulushi, Naeema; Jawa, Zabah; Tag, Naima; Shehzad Afzal, Muhammad; Fatima, Shazia; Numair Younis, Muhammad; Riaz, Musab; Saadullah, Mohammad; Herrera, Yariela; Lenturut-Katal, Dora; Castillo V('(a))zquez, Manuel; Ortellado, Jos('(e)); Akhter, Afroza; Cao, Dianbo; Cheung, Stephen; Dai, Xu; Gong, Lianggeng; Han, Dan; Hou, Yang; Li, Caiying; Li, Tao; Li, Dong; Li, Sijin; Liu, Jinkang; Liu, Hui; Yen Ng, Ming; Sun, Kai; Tang, Gongshun; Wang, Jian; Wang, Ximing; Wang, Zhao-Qian; Wang, Yining; Wang, Yifan; Wu, Jiang; Wu, Zhifang; Xia, Liming; Xiao, Jiangxi; Xu, Lei; Yang, Youyou; Yin, Wu; Yu, Jianqun; Yuan, Li; Zhang, Tong; Zhang, Longjiang; Zhang, Yong-Gao; Zhang, Xiaoli; Zhu, Li; Alfaro, Ana; Abrihan, Paz; Barroso, Asela; Cruz, Eric; Rhiamar Gomez, Marie; Peter Magboo, Vincent; Michael Medina, John; Obaldo, Jerry; Pastrana, Davidson; Michael Pawhay, Christian; Quinon, Alvin; Margareth Tang, Jeanelle; Tecson, Bettina; Joy Uson, Kristine; Uy, Mila; Kostkiewicz, Magdalena; Kunikowska, Jolanta; Bettencourt, Nuno; Cantinho, Guilhermina; Ferreira, Antonio; Syed, Ghulam; Arnous, Samer; Atyani, Said; Byrne, Angela; Gleeson, Tadhg; Kerins, David; Meehan, Conor; Murphy, David; Murphy, Mark; Murray, John; O( extquotesingle)Brien, Julie; Bang, Ji-In; Bom, Henry; Cho, Sang-Geon; Moon Hong, Chae; Jin Jang, Su; Hyu Jeong, Yong; Jun Kang, Won; Kim, Ji-Young; Lee, Jaetae; Kyeong Namgung, Chang; So, Young; Sook Won, Kyoung; Majstorov, Venjamin; Vavlukis, Marija; Gu(&#xb; (z))ic Salobir, Barbara; (&#xb; (S))talc, Monika; Benedek, Theodora; Benedek, Imre; Mititelu, Raluca; Adrian Stan, Claudiu; Ansheles, Alexey; Dariy, Olga; Drozdova, Olga; Gagarina, Nina; Milyevich Gulyaev, Vsevolod; Itskovich, Irina; Karalkin, Anatoly; Kokov, Alexander; Migunova, Ekaterina; Pospelov, Viktor; Ryzhkova, Daria; Saifullina, Guzaliya; Sazonova, Svetlana; Shurupova, Irina; Trifonova, Tatjana; Yurievich Ussov, Wladimir; Vakhromeeva, Margarita; Valiullina, Nailya; Zavadovsky, Konstantin; Zhuravlev, Kirill; Alasnag, Mirvat; Okarvi, Subhani; Sobic Saranovic, Dragana; Keng, Felix; Hao Jason See, Jia; Sekar, Ramkumar; Sen Yew, Min; Vondrak, Andrej; Bejai, Shereen; Bennie, George; Bester, Ria; Engelbrecht, Gerrit; Evbuomwan, Osayande; Gongxeka, Harlem; Jv Vuuren, Magritha; Kaplan, Mitchell; Khushica, Purbhoo; Lakhi, Hoosen; Malan, Nico; Milos, Katarina; Modiselle, Moshe; More, Stuart; Naidoo, Mathava; Scholtz, Leonie; Vangu, Mboyo; Aguad('(e))-Bruix, Santiago; Blanco, Isabel; Cabrera, Antonio; Camarero, Alicia; Cas('(a))ns-Tormo, Irene; Cuellar-Calabria, Hug; Flotats, Albert; Eugenia Fuentes Ca(\~(n))amero, Maria; Elia Garc('(\i))a, Mar('(\i))a; Jimenez-Heffernan, Amelia; Leta, Rub('(e))n; Lopez Diaz, Javier; Lumbreras, Luis; Javier Marquez-Cabeza, Juan; Martin, Francisco; Martinez de Alegria, Anxo; Medina, Francisco; Pedrera Canal, Maria; Peiro, Virginia; Pubul-Nu(\~(n))ez, Virginia; Ignacio Rayo Madrid, Juan; Rodr('(\i))guez Rey, Cristina; Ruano Perez, Ricardo; Ruiz, Joaqu('(\i))n; Sabatel Hern('(a))ndez, Gertrudis; Sevilla, Ana; Zeid('(a))n, Nahla; Nanayakkara, Damayanthi; Udugama, Chandraguptha; Simonsson, Magnus; Alkadhi, Hatem; Ralf Buechel, Ronny; Burger, Peter; Ceriani, Luca; De Boeck, Bart; Gräni, Christoph; Juillet de Saint Lager Lucas, Alix; Kamani, Christel H.; Kawel-Boehm, Nadine; Manka, Robert; Prior, John O.; Rominger, Axel; Vall('(e))e, Jean-Paul; Khiewvan, Benjapa; Premprabha, Teerapon; Thientunyakit, Tanyaluck; Sellem, Ali; Metin Kir, Kemal; Sayman, Haluk; Julius Sebikali, Mugisha; Muyinda, Zerida; Kmetyuk, Yaroslav; Korol, Pavlo; Mykhalchenko, Olena; Pliatsek, Volodymyr; Satyr, Maryna; Albalooshi, Batool; Ismail Ahmed Hassan, Mohamed; Anderson, Jill; Bedi, Punit; Biggans, Thomas; Bularga, Anda; Bull, Russell; Burgul, Rajesh; Carpenter, John-Paul; Coles, Duncan; Cusack, David; Deshpande, Aparna; Dougan, John; Fairbairn, Timothy; Farrugia, Alexia; Gopalan, Deepa; Gummow, Alistair; Guntur Ramkumar, Prasad; Hamilton, Mark; Harbinson, Mark; Hartley, Thomas; Hudson, Benjamin; Joshi, Nikhil; Kay, Michael; Kelion, Andrew; Khokhar, Azhar; Kitt, Jamie; Lee, Ken; Low, Chen; Mun Mak, Sze; Marousa, Ntouskou; Martin, Jon; Mcalindon, Elisa; Menezes, Leon; Morgan-Hughes, Gareth; Moss, Alastair; Murray, Anthony; Nicol, Edward; Patel, Dilip; Peebles, Charles; Pugliese, Francesca; Carl Luis Rodrigues, Jonathan; Rofe, Christopher; Sabharwal, Nikant; Schofield, Rebecca; Semple, Thomas; Sharma, Naveen; Strouhal, Peter; Subedi, Deepak; Topping, William; Tweed, Katharine; Weir-Mccall, Jonathan; Abbara, Suhny; Abbasi, Taimur; Abbott, Brian; Abohashem, Shady; Abramson, Sandra; Al-Abboud, Tarek; Al-Mallah, Mouaz; Almousalli, Omar; Ananthasubramaniam, Karthikeyan; Ashok Kumar, Mohan; Askew, Jeffrey; Attanasio, Lea; Balmer-Swain, Mallory; Bayer, Richard R.; Bernheim, Adam; Bhatti, Sabha; Bieging, Erik; Blankstein, Ron; Bloom, Stephen; Blue, Sean; Bluemke, David; Borges, Andressa; Branch, Kelley; Bravo, Paco; Brothers, Jessica; Budoff, Matthew; Bullock-Palmer, Ren('(e))e; Burandt, Angela; Burke, Floyd W.; Bush, Kelvin; Candela, Candace; Capasso, Elizabeth; Cavalcante, Joao; Chang, Donald; Chatterjee, Saurav; Chatzizisis, Yiannis; Cheezum, Michael; Chen, Tiffany; Chen, Jennifer; Chen, Marcus; Choi, Andrew; Clarcq, James; Cordero, Ayreen; Crim, Matthew; Danciu, Sorin; Decter, Bruce; Dhruva, Nimish; Doherty, Neil; Doukky, Rami; Dunbar, Anjori; Duvall, William; Edwards, Rachael; Esquitin, Kerry; Farah, Husam; Fentanes, Emilio; Ferencik, Maros; Fisher, Daniel; Fitzpatrick, Daniel; Foster, Cameron; Fuisz, Tony; Gannon, Michael; Gastner, Lori; Gerson, Myron; Ghoshhajra, Brian; Goldberg, Alan; Goldner, Brian; Gonzalez, Jorge; Gore, Rosco; Gracia-L('(o))pez, Sandra; Hage, Fadi; Haider, Agha; Haider, Sofia; Hamirani, Yasmin; Hassen, Karen; Hatfield, Mallory; Hawkins, Carolyn; Hawthorne, Katie; Heath, Nicholas; Hendel, Robert; Hernandez, Phillip; Hill, Gregory; Horgan, Stephen; Huffman, Jeff; Hurwitz, Lynne; Iskandrian, Ami; 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[10.1016/j.jacc.2020.10.054]

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

Francesco Bianco;
2021-01-01

Abstract

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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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11566/327597
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