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. 2022 Jun 16:2022:7923228.
doi: 10.1155/2022/7923228. eCollection 2022.

Impact of the COVID-19 Pandemic on Trends in Cardiothoracic Imaging

Kathleen M Capaccione  1 , Sophia Huang  1 , Jay S Leb  1 , Belinda D'souza  1 , Jonathan Goldstein  1 , Mary M Salvatore  1
Affiliations

Impact of the COVID-19 Pandemic on Trends in Cardiothoracic Imaging

Kathleen M Capaccione et al. Radiol Res Pract. .

Abstract

Introduction: Here, we evaluate the effect of the COVID-19 pandemic on utilization of cardiothoracic imaging studies.

Methods: We queried our radiology record system to retrospectively identify numbers of specific key cardiothoracic imaging studies for five years prior and during the COVID-19 pandemic. Statistical analysis was performed to evaluate changes in the number of exams in 2020 and 2021 compared to 2019.

Results: Five-year retrospective analysis demonstrated progressive increases in nearly all cross-sectional studies. In 2020, daily chest radiograph utilization decreased with an overall number of daily radiographs of 406 (SD = 73.1) compared to 480 per day in 2019 (SD = 82.6) (p < 0.0001). Portable radiograph utilization was increased in 2020 averaging 320 (SD = 68.2) films daily in 2020 compared to 266 (SD = 29.1) in 2019 (p < 0.0001). Utilization of thoracic CT was decreased during the pandemic, with 21.8 (SD = 12.9) studies daily compared to 52.0 (SD = 21.4) (p < 0.0001) studies daily in 2019. Cardiac imaging utilization was also substantially decreased in 2020 compared to 2019, averaging a total of 3.8 (SD = 3.2) versus 10.8 (SD = 6.6) studies daily and 0.88 (SD = 1.7) versus 2.5 (SD = 2.3) studies daily for CT and MRI, respectively. Evaluation of cardiothoracic imaging for the subsequent 18 months after New York's entry to phase I recovery in June 2020 demonstrated that by one year after the emergence of COVID-19 imaging utilization had recovered to prepandemic levels. Cardiac imaging continued to increase throughout the chronic phase of the COVID-19 pandemic, reaching almost twice the prepandemic levels by the end of 2021.

Conclusion: COVID-19 has had far-reaching effects on medicine and public health. Here, we demonstrate decreases in all cross-sectional cardiothoracic imaging studies, closely mirroring findings in other fields during the height of the pandemic, which have since rebounded.

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Conflict of interest statement

The authors are employed by New York Presbyterian-Columbia University Irving Medical Center. Mary M. Salvatore is the speaker and consultant at Genentech, Boehringer Ingelheim and obtained grant funding from Genentech, Boehringer Ingelheim. The remaining authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Five-year trends in utilization of key cardiothoracic imaging exams: (a) chest radiograph, (b) chest CT, (c) cardiac CT, and (d) cardiac MRI. In all cross-sectional modalities, there was a progressive increase in the number of studies over time. Chest radiograph utilization progressively increased over time although it demonstrated a small decline in 2019.
Figure 2
Figure 2
Chest radiograph utilization. (a) Daily chest radiograph utilization for 2020 and 2019, respectively. In 2020, there were statistically significantly fewer radiographs obtained, and there was a trend of decreased utilization throughout the course of the pandemic. (b) Daily trends in portable chest radiograph utilization for 2020 and 2019, showing increasing use as the pandemic peaked and then declining as fewer patients were hospitalized. Dashed lines represent polynomial lines of best fit.
Figure 3
Figure 3
Daily change in % portable chest radiograph in 2020 compared to 2019. Polynomial line of best fit indicates that the peak of portable radiograph utilization coincided with the height of the pandemic in our region. Dashed line represents polynomial line of best fit.
Figure 4
Figure 4
Total daily thoracic CT utilization. At the height of the pandemic, there was greater than 100% decrease in overall daily chest CT utilization. The decline in utilization was inversely related to the number of hospitalized COVID-19 cases, and it increased as fewer patients were hospitalized. Dashed lines represent polynomial lines of best fit.
Figure 5
Figure 5
Weekly cardiac CT utilization in 2020 and 2019. Analysis showed a significantly decreased number of cardiac CT studies in 2020 during the COVID-19 pandemic, with the greatest decrease early in the study period. Dashed lines represent polynomial lines of best fit.
Figure 6
Figure 6
Weekly cardiothoracic MR utilization. Overall cardiothoracic MR imaging utilization during the study period, with a dramatically decreased number of exams obtained in 2020 compared to 2019. Dashed lines represent polynomial lines of best fit.
Figure 7
Figure 7
Cardiothoracic imaging utilization after the acute phase of the COVID-19 pandemic. Our data demonstrate that, by early 2021, utilization of all types of cardiothoracic exams had returned to prepandemic levels. Furthermore, both cardiac CT and cardiac MRI utilization exceeded prepandemic levels after recovering from the acute phase of the COVID-19 pandemic and have continued to increase despite the ongoing global health crisis. By the end of 2021, use of some exams was close to 200% of prepandemic levels.
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