Background: Cardiology divisions reshaped their activities during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to analyze the organization of echocardiographic laboratories and echocardiography practice during the second wave of the COVID-19 pandemic in Italy, and the expectations for the post-COVID era. Methods: We analyzed two different time periods: the month of November during the second wave of the COVID-19 pandemic (2020) and the identical month during 2019 (November 2019). Results: During the second wave of the COVID-19 pandemic, the hospital activity was partially reduced in 42 (60%) and wholly interrupted in 3 (4%) echocardiographic laboratories, whereas outpatient echocardiographic activity was partially reduced in 41 (59%) and completely interrupted in 7 (10%) laboratories. We observed an important change in the organization of activities in the echocardiography laboratory which reduced the operator-risk and improved self-protection of operators by using appropriate personal protection equipment. Operators wore FFP2 in 58 centers (83%) during trans-thoracic echocardiography (TTE), in 65 centers (93%) during transesophageal echocardiography (TEE) and 63 centers (90%) during stress echocardiography. The second wave caused a significant reduction in number of echocardiographic exams, compared to November 2019 (from 513 ± 539 to 341 ± 299 exams per center, −34%, p < 0.001). On average, there was a significant increase in the outpatient waiting list for elective echocardiographic exams (from 32.0 ± 28.1 to 45.5 ± 44.9 days, +41%, p < 0.001), with a reduction of in-hospital waiting list (2.9 ± 2.4 to 2.4 ± 2.0 days, −17%, p < 0.001). We observed a large diffusion of point-of-care cardiac ultrasound (88%), with a significant increase of lung ultrasound usage in 30 centers (43%) during 2019, extended to all centers in 2020. Carbon dioxide production by examination is an indicator of the environmental impact of technology (100-fold less with echocardiography compared to other cardiac imaging techniques). It was ignored in 2019 by 100% of centers, and currently it is considered potentially crucial for decision-making in cardiac imaging by 65 centers (93%). Conclusions: In one year, major changes occurred in echocardiography practice and culture. The examination structure changed with extensive usage of point-of-care cardiac ultrasound and with lung ultrasound embedded by default in the TTE examination, as well as the COVID-19 testing.

Reshaping of italian echocardiographic laboratories activities during the second wave of covid-19 pandemic and expectations for the post-pandemic era / Q. Ciampi, F. Antonini-Canterin, A. Barbieri, A. Barchitta, F. Benedetto, A. Cresti, S. Miceli, I. Monte, L. Petrella, G. Trocino, I. Aquila, G. Barbati, V. Barletta, D. Barone, M. Beraldi, G. Bergandi, G. Bilardo, G. Boriani, E. Bossone, A. Bongarzoni, F.E. Bovolato, F. Bursi, V. Cammalleri, M. Carbonella, G. Casavecchia, S. Cicco, G. Cioffi, R. Cocchia, P. Colonna, L. Cortigiani, U. Cucchini, M.G. D'alfonso, A. D'andrea, L. Dell'angela, I. Dentamaro, M. De Paolis, P. De Stefanis, W. Deste, M. Di Fulvio, G. Di Giannuario, D. Di Lisi, C. Di Nora, I. Fabiani, R. Esposito, F. Fazzari, L. Ferrara, G. Filice, D. Forno, M. Giorgi, E. Giustiniano, C.A. Greco, G.L. Iannuzzi, A. Izzo, A.M. Lanzone, A. Malagoli, F. Mantovani, V. Manuppelli, S. Mega, E. Merli, M. Ministeri, D. Morrone, C. Napoletano, L. Nunziata, G. Pastorini, C. Pedone, E. Petruccelli, M.V. Polito, V. Polizzi, C. Prota, F. Rigo, D.E. Rivaben, S. Saponara, A. Sciacqua, C. Sartori, V. Scarabeo, W. Serra, S. Severino, L. Spinelli, G. Tamborini, A. Tota, B. Villari, S. Carerj, E. Picano, M. Pepi. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 10:16(2021 Aug 05), pp. 3466.1-3466.9. [10.3390/jcm10163466]

Reshaping of italian echocardiographic laboratories activities during the second wave of covid-19 pandemic and expectations for the post-pandemic era

A. Barbieri;F. Bursi;
2021-08-05

Abstract

Background: Cardiology divisions reshaped their activities during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to analyze the organization of echocardiographic laboratories and echocardiography practice during the second wave of the COVID-19 pandemic in Italy, and the expectations for the post-COVID era. Methods: We analyzed two different time periods: the month of November during the second wave of the COVID-19 pandemic (2020) and the identical month during 2019 (November 2019). Results: During the second wave of the COVID-19 pandemic, the hospital activity was partially reduced in 42 (60%) and wholly interrupted in 3 (4%) echocardiographic laboratories, whereas outpatient echocardiographic activity was partially reduced in 41 (59%) and completely interrupted in 7 (10%) laboratories. We observed an important change in the organization of activities in the echocardiography laboratory which reduced the operator-risk and improved self-protection of operators by using appropriate personal protection equipment. Operators wore FFP2 in 58 centers (83%) during trans-thoracic echocardiography (TTE), in 65 centers (93%) during transesophageal echocardiography (TEE) and 63 centers (90%) during stress echocardiography. The second wave caused a significant reduction in number of echocardiographic exams, compared to November 2019 (from 513 ± 539 to 341 ± 299 exams per center, −34%, p < 0.001). On average, there was a significant increase in the outpatient waiting list for elective echocardiographic exams (from 32.0 ± 28.1 to 45.5 ± 44.9 days, +41%, p < 0.001), with a reduction of in-hospital waiting list (2.9 ± 2.4 to 2.4 ± 2.0 days, −17%, p < 0.001). We observed a large diffusion of point-of-care cardiac ultrasound (88%), with a significant increase of lung ultrasound usage in 30 centers (43%) during 2019, extended to all centers in 2020. Carbon dioxide production by examination is an indicator of the environmental impact of technology (100-fold less with echocardiography compared to other cardiac imaging techniques). It was ignored in 2019 by 100% of centers, and currently it is considered potentially crucial for decision-making in cardiac imaging by 65 centers (93%). Conclusions: In one year, major changes occurred in echocardiography practice and culture. The examination structure changed with extensive usage of point-of-care cardiac ultrasound and with lung ultrasound embedded by default in the TTE examination, as well as the COVID-19 testing.
COVID-19; Lung ultrasound; Point-of-care cardiac ultrasound
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/867529
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