Time series analysis of the demand for COVID-19 related chest imaging during the first wave of the SARS-CoV-2 pandemic: An explorative study

Abstract

Objectives The aim of this study was to investigate possible patterns of demand for chest imaging during the first wave of the SARS-CoV-2 pandemic and derive a decision aid for the allocation of resources in future pandemic challenges. Materials and methods Time data of requests for patients with suspected or confirmed coronavirus disease 2019 (COVID-19) lung disease were analyzed between February 27th and May 27th 2020. A multinomial logistic regression model was used to evaluate differences in the number of requests between 3 time intervals (I1: 6am - 2pm, I2: 2pm - 10pm, I3: 10pm - 6am). A cosinor model was applied to investigate the demand per hour. Requests per day were compared to the number of regional COVID-19 cases. Results 551 COVID-19 related chest imagings (32.8% outpatients, 67.2% in-patients) of 243 patients were conducted (33.3% female, 66.7% male, mean age 60 ± 17 years). Most exams for outpatients were required during I2 (I1 vs. I2: odds ratio (OR) = 0.73, 95% confidence interval (CI) 0.62–0.86, p = 0.01; I2 vs. I3: OR = 1.24, 95% CI 1.04–1.48, p = 0.03) with an acrophase at 7:29 pm. Requests for in-patients decreased from I1 to I3 (I1 vs. I2: OR = 1.24, 95% CI 1.09–1.41, p = 0.01; I2 vs. I3: OR = 1.16, 95% CI 1.05–1.28, p = 0.01) with an acrophase at 12:51 pm. The number of requests per day for outpatients developed similarly to regional cases while demand for in-patients increased later and persisted longer. Conclusions The demand for COVID-19 related chest imaging displayed distinct distribution patterns depending on the sector of patient care and point of time during the SARS-CoV-2 pandemic. These patterns should be considered in the allocation of resources in future pandemic challenges with similar disease characteristics.

COVID‐19 pandemic and the effect of increased utilisation of mobile X‐ray examinations on radiation dose to radiographers

“…This was to help manage increases in patient presentations during viral surges and manage workflow. This staffing adjustment is supported by Koehler et al, who investigated the demand for chest imaging during the pandemic’s first wave 37 . The greatest demand for chest imaging was between 2 and 10 pm for emergency patients and 6 am to 2 pm for inpatient requests 37 .…”

“… 37 The greatest demand for chest imaging was between 2 and 10 pm for emergency patients and 6 am to 2 pm for inpatient requests. 37 The radiographers rostered to mobiles did not separate into teams without crossover; however, others considered this work practice. 5 While additional staff may improve workflow during the peak period, health services are well placed to manage any changes in demand.…”

“…This staffing adjustment is supported by Koehler et al, who investigated the demand for chest imaging during the pandemic’s first wave 37 . The greatest demand for chest imaging was between 2 and 10 pm for emergency patients and 6 am to 2 pm for inpatient requests 37 . The radiographers rostered to mobiles did not separate into teams without crossover; however, others considered this work practice 5 .…”

Imaging volumes during COVID-19: A Victorian health service experience

“…We also observed that fixed X-ray imaging decreased when adult mobile imaging increased in the emergency setting. This was likely to reduce transmission risk and manage potential increased demand[ 8 , 32 ]. The greatest impact on adult mobile imaging usage was observed during the pandemic’s second wave, when the risk of cold and influenza was heightened (July-September 2020)[ 33 ].…”