ABSTRACT
BACKGROUND: In response to COVID-19 pandemic state restrictions, our institution deferred elective procedures from 3/15/2020 to 6/13/2020, and removed cardiology fellows from the echocardiography rotation to staff clinical services. We assessed the impact of the COVID-19 pandemic on fellow education and echocardiography volumes. METHODS: Our institutional database was used to examine volumes of transthoracic (TTE), stress (SE), and transesophageal echocardiograms (TEE) from 7/1/2018 to 10/10/2020. Study volumes were compared in three intervals: pre-pandemic (7/1/2018- 3/14/2020), pandemic (3/15/2020-6/13/2020), and pandemic recovery (6/14/2020-10/10/2020). We examined weekly number of TTEs performed or interpreted by cardiology fellows during the study period, and compared these to the two previous academic years. RESULTS: Weekly TTE volume declined by 54% during the pandemic, and increased by 99% during pandemic recovery, (p < 0.05). SE and TEE revealed similar trends. A strong correlation between weekly TTE volume and inpatient admissions was observed during the study period (rs=0.67, p < 0.05). Weekly fellow TTE scans declined by 78% during the pandemic, with a 380% increase during pandemic recovery (p < 0.05). Weekly fellow TTE interpretations declined by 56% during the pandemic, with a 76% increase during pandemic recovery (p < 0.05). CONCLUSION: COVID restrictions between 3/15/2020- 6/14/2020 coincided with a marked decline in TTE, SE, and TEE volumes, with an increase similar to near pre-pandemic volumes during the pandemic recovery period. A similar decline with the onset of COVID restrictions, and increase to pre-restriction volumes thereafter was observed with fellow scans and interpretations, but total academic year fellow training volumes remained depressed. With the ongoing COVID-19 pandemic and rise of multiple variants, training programs may need to adjust fellows' clinical responsibilities so as to support achievement of echocardiography training certification.
Subject(s)
COVID-19 , Cardiology , Internship and Residency , Humans , Pandemics , COVID-19/epidemiology , Echocardiography , Cardiology/educationSubject(s)
Cardiomyopathies , Coronavirus Infections , Pandemics , Pneumonia, Viral , Takotsubo Cardiomyopathy/epidemiology , Betacoronavirus , COVID-19 , Humans , SARS-CoV-2ABSTRACT
During the peak phase of the COVID-19 pandemic, alterations of standard operating procedures were necessary for health systems to protect patients and healthcare workers and ensure access to vital hospital resources. As the peak phase passes, re-activation plans are required to safely manage increasing clinical volumes. In the context of cardiovascular magnetic resonance (CMR), re-activation objectives include continued performance of urgent CMR studies and resumption of CMR in patients with semi-urgent and elective indications in an environment that is safe for both patients and health care workers.
Subject(s)
Betacoronavirus , Cardiovascular Diseases/diagnostic imaging , Coronavirus Infections/prevention & control , Magnetic Resonance Imaging/methods , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , COVID-19 , Cardiovascular System/diagnostic imaging , Humans , Predictive Value of Tests , SARS-CoV-2 , Societies, MedicalSubject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/virology , Myocarditis/virology , Pneumonia, Viral/virology , Takotsubo Cardiomyopathy/virology , Ventricular Function, Left , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Female , Host Microbial Interactions , Humans , Middle Aged , Myocarditis/diagnosis , Myocarditis/physiopathology , Myocarditis/therapy , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Risk Factors , SARS-CoV-2 , Takotsubo Cardiomyopathy/diagnosis , Takotsubo Cardiomyopathy/physiopathology , Takotsubo Cardiomyopathy/therapy , Treatment OutcomeABSTRACT
The aim of this document is to provide general guidance and specific recommendations on the practice of cardiovascular magnetic resonance (CMR) in the era of the COVID-19 pandemic. There are two major considerations. First, continued urgent and semi-urgent care for the patients who have no known active COVID-19 should be provided in a safe manner for both patients and staff. Second, when necessary, CMR on patients with confirmed or suspected active COVID-19 should focus on the specific clinical question with an emphasis on myocardial function and tissue characterization while optimizing patient and staff safety.