Diagnostic cardiovascular procedures declined an average of 47% in Asia in March 2020 compared to March 2019, with the greatest declines seen in low-income countries – some of which saw up to 80% declines, according to research published Sept. 21 in JACC: Asia looking at the impact of the COVID-19 pandemic on cardiovascular care.

Takashi Kudo, MD, PhD, et al., looked at data from the International Atomic Energy Agency Division of Human Health Non-invasive Cardiology Protocols of COVID study (INCAPS COVID), the first study to look at the impact of COVID-19 on cardiovascular disease procedural volumes, to conduct a sub-study evaluating the effects of the early phase of the COVID-19 pandemic on cardiovascular diagnostic procedures and safety practices in Asia, the first region impacted by COVID-19.

Testing volumes were reported for March and April 2020 and compared to those from March 2019. Data from 180 centers across 33 Asian countries were grouped into four sub-regions for comparison. Researchers found that procedure volumes decreased by 47% from March 2019 to March 2020, but Eastern Asia, particularly China, saw early recovery of the decline from March 2020 to April 2020. The most severe reductions in procedure volumes were observed in lower income countries, where volumes decreased 80% from March 2019 to April 2020. The majority of the centers looked at had implemented COVID-19 protocols that included canceling outpatient activities, increasing time per study to allow for cleaning and disinfecting, implementing physical distancing and restricting visitors, all of which contributed to procedural declines.

“The rapid global spread of COVID-19 has changed the global economy and social environment and has had a negative impact on routine medical practice, particularly the diagnostic evaluation of cardiovascular disease,” said Kudo. “Further study is warranted to determine the impact of the COVID-19 pandemic on cardiovascular disease morbidity and mortality, as well as to develop strategies to maintain essential health care services like cardiac diagnostics in a resurgence of COVID-19 or in future pandemics.”

In a related editorial comment, Pranav M. Patel, MD, FACC, said there is hope that although there was initial chaos around global cardiovascular testing in the early days of the pandemic, later responses show that countries and policies are becoming more harmonious.

“These new challenges with the pandemic are improving our skills and teaching us how to enhance cardiovascular care,” Patel said. “As with the current study, we should also encourage further research until we truly understand the global impact of this pandemic on the cardiovascular care of our patients.”

Clinical Topics: COVID-19 Hub

Keywords: ACC International, Delivery of Health Care, Social Environment, Cardiology, Policy, Health Services, Cardiovascular System, Morbidity, Asia, Physical Distancing, COVID-19 Testing, Outpatients, Cardiovascular Diseases, Disinfectants, COVID-19

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