Impact of the COVID-19 pandemic on the activity of the Radiological Emergency Department: the experience of the Maggiore della Carità Hospital in Novara

Abstract

Purpose During the first peak of the COVID-19 pandemic, the activity of Emergency Departments worldwide changed dramatically, focusing on diagnosis and care of the Sars-Cov-2 associated disease. These major changes also involved the activity of the Emergency Radiology Department (ERD). This study aimed to analyse the impact of the COVID-19 pandemic on imaging studies, both in terms of the amount, frequency and subspecialty of different imaging modalities requested to the ERD of the Maggiore della Carità Hospital in Novara (Italy). Methods To this end, our observational study took into account the imaging studies requested by the emergency department during three-time spans. These were defined as phase 0 (pre-pandemic), phase 1 (pandemic peak with complete lockdown) and phase 2 (post-pandemic peak with partial lifting of restrictive measures), as derived from Italian urgent decrees by the President of the Council of Ministers (DPCM) which established the duration and entity of the lockdown measures throughout the pandemic. The dataset was processed and then compared with Pearson’s chi-squared test. Results During the pandemic peak, our data showed a significant drop in the total number of studies requested and a significant rise in computed tomography (CT) studies. In particular, a statistically significant increase in chest CT studies was found, probably due to the high sensitivity of this imaging method in identifying pulmonary involvement during respiratory tract infection of possible viral etiology (SARS-Cov-2). Moreover, we observed a statistically significant decrease of X-ray (XR) and ultrasound (US) studies during phase 1 compared to phase 0 and phase 2 probably due to a reduction in the numbers of ER visits for minor traumas given the mobility restrictions and people hesitancy in visiting the ER due to fear of contagion. Conclusions We can conclude that the activity of the ERD was heavily impacted by the SARS-Cov-2 pandemic. Further studies will be needed to estimate the impact of the pandemic on public health in terms of excess mortality related to delayed diagnosis and care of non-COVID diseases.

The impact of the COVID-19 pandemic on the use of diagnostic imaging examinations in the Brazilian unified healthcare system (SUS)

“…Naidich et al [13] showed that chest CT angiography increased among inpatients in a large healthcare system in the US in the first 16 weeks of 2020. Increased chest CT use in accordance with the local epidemic spreading was also reported in French [14] and Italian [16] radiological centers and by other authors in Brazil [15] . The increased use of chest CT during the COVID-19 pandemic is not unforeseen as the severe forms of the disease are largely associated to the extent of pulmonary involvement and chest CT has a recognized role in assessing severity and progression of the disease.…”

“…Mammography, nuclear medicine, and magnetic resonance imaging were among the most affected modalities [10] , [11] , [12] . Nevertheless, the use of imaging examinations for the diagnosis and management of COVID-19, particularly chest computed tomography (CT) increased [13] , [14] , [15] , [16] .…”

Impact of Insurance Benefits and Education on Point-of-Care Ultrasound Use in a Single Emergency Department: An Interrupted Time Series Analysis

“…In addition, it was not easy to apply ultrasound due to problems associated with wearing personal protective equipment before and after the POCUS scan, as well as disinfection of machines. Although many studies have recommended the use of lung ultrasound in the COVID-19 pandemic [38][39][40], the use of ultrasound has significantly reduced in our institution, as reported in other studies [41,42].…”

Trends in outpatient shoulder arthroplasty during the COVID-19 (coronavirus disease 2019) era: increased proportion of outpatient cases with decrease in 90-day readmissions

“…Several recently published studies have shown fewer ED visits for matters unrelated to COVID-19 since the pandemic began, likely owing to initial mobility restrictions and fear of contagion. 3,13 However, the greatest reduction in ED visits was seen during the early portion of the pandemic, 14 when most elective surgical procedures were also paused by government mandate, making it unclear how large a confounding factor this would be for our particular study. Therefore, our results showing fewer ED visits and readmissions could be attributable to the initial fear of going to the hospital.…”