Rodrigo Julio Cerci et al. João Vicente Vitola Diana Paez Alejandro Zuluaga … Marcio Sommer Bittencourt Lilia M. Sierra-Galan Patricia Carrascosa Roxana Campisi Claudia Gutierrez-Villamil Amalia Peix Duane Chambers Mayra Sánches Velez Carla M. G. Alvarado Ana C. F. Ventura Alejandro Maldonado Alfredo P. Castanos Teresa C. Diaz Yariela Herrera Manuel C. Vasquez Ana A. Arrieta Fernando Mut Cole Hirschfeld Eli Malkovskiy Benjamin Goebel Yosef Cohen Michael Randazzo Leslee J. Shaw Michelle C. Williams Todd C. Villines Nathan Better Sharmila Dorbala Paolo Raggi Thomas N. B. Pascual Yaroslav Pynda Maurizio Dondi Andrew J. Einstein
Abstract
Background
The COVID-19 pandemic has disrupted the delivery of care for cardiovascular diseases in Latin America. However, the effect of the pandemic on the cardiac diagnostic procedure volumes has not been quantified.
Objective
To assess (1) the impact of COVID-19 on cardiac diagnostic volumes in Latin America and (2) determine its relationship with COVID-19 case incidence and social distancing measures.
Methods
The International Atomic Energy Agency conducted a worldwide survey assessing changes in cardiac diagnostic volumes resulting from COVID-19. Cardiac diagnostic volumes were obtained from participating sites for March and April 2020 and compared to March 2019. Social distancing data were collected from Google COVID-19 community mobility reports and COVID-19 incidence per country from the Our World in Data.
Results
Surveys were conducted in 194 centers performing cardiac diagnostic procedures, in 19 countries in Latin America. Procedure volumes decreased 36% from March 2019 to March 2020, and 82% from March 2019 to April 2020. The greatest decreases occurred in echocardiogram stress tests (91%), exercise treadmill tests (88%), and computed tomography calcium scores (87%), with slight variations between sub-regions of Latin America. Changes in social distancing patterns (p < 0.001) were more strongly associated with volume reduction than COVID-19 incidence (p = 0.003).
Conclusions
COVID-19 was associated with a significant reduction in cardiac diagnostic procedures in Latin America, which was more related to social distancing than to the COVID-19 incidence. Better balance and timing of social distancing measures and planning to maintain access to medical care is warranted during a pandemic surge, especially in regions with high cardiovascular mortality.