Media release

From: American College of Cardiology

International Impact of COVID-19 on the Diagnosis of Heart Disease

The COVID-19 pandemic caused health care delivery disruptions across the globe in 2020, including delays in cardiovascular disease diagnosis and timely treatment. Heart disease is the No. 1 killer worldwide, and outcomes are dependent on early and effective diagnosis to determine the best possible treatment.

In this study researchers sought to determine the full magnitude of reductions in diagnostic heart disease procedures in 2020 and how that might impact long-term cardiovascular disease outcomes.

Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures in 108 countries.

According to researchers, procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020.

Specifically, transthoracic echocardiography decreased by 59%, transesophageal echocardiography by 76%, and stress tests by 78%. Coronary angiography (invasive or computed tomography) decreased 55%.

Researchers also classified countries into four economic levels (low, lower-middle, upper-middle and high) and found that location in a low/lower-middle income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth.

“These findings raise serious concerns for long-term adverse cardiovascular health outcomes resulting from decreased diagnosis,” said Andrew J. Einstein, MD, PhD, lead author of the study, associate professor of medicine at Columbia University Vagelos College of Physicians and Surgeons, and a cardiologist at New York-Presbyterian/Columbia University Irving Medical Center.

“Efforts to improve timely patient access to cardiovascular diagnosis in this and future pandemics, particularly in low- and middle-income countries, are warranted.”