RESUMEN
PURPOSE: The purpose of this study was to assess the efficacy of transarterial embolization in COVID-19 patients with an arterial bleeding and to investigate differences between various patient groups concerning survival. METHOD: We retrospectively reviewed COVID-19 patients undergoing transarterial embolization due to an arterial bleeding in a multicenter study from April 2020 to July 2022 and analyzed the technical success of embolization and survival rate. 30-day survival between various patient groups was analyzed. The Chi- square test and Fisher's exact test were used for testing association between the categorical variables. RESULTS: 53 COVID-19 patients (age: 57.3 ± 14.3 years, 37 male) received 66 angiographies due to an arterial bleeding. The initial embolization was technically successful in 98.1% (52/53). In 20.8% (11/53) of patients, additional embolization was necessary due to a new arterial bleeding. A majority of 58.5% (31/53) had a severe course of COVID-19 infection necessitating ECMO-therapy and 86.8% (46/53) of patients received anticoagulation. 30-day survival rate in patients with ECMO-therapy was significantly lower than without ECMO-therapy (45.2% vs. 86.4%, p = 0.004). Patients with anticoagulation did not have a lower 30-day survival rate than without anticoagulation (58.7% vs. 85.7%, p = 0.23). COVID-19 patients with ECMO-therapy developed more frequently a re-bleeding after embolization than non-ECMO-patients (32.3% vs. 4.5%, p = 0.02). CONCLUSIONS: Transarterial embolization is a feasible, safe, and effective procedure in COVID-19 patients with arterial bleeding. ECMO-patients have a lower 30-day survival rate than non-ECMO-patients and have an increased risk for re-bleeding. Treatment with anticoagulation could not be identified as a risk factor for higher mortality.
RESUMEN
OBJECTIVES: To find out the opinion of radiological inpatient and outpatient medical staff regarding the measures taken in relation to the COVID-19 pandemic during the first and second waves and to identify the measures that are still perceived as needing improvement. MATERIALS AND METHODS: We conducted an anonymous online survey among more than 10â000 radiologists/technicians in Germany from January 5 to January 31, 2021. A total of 862 responses (head physicians, nâ=â225 [inpatient doctors, nâ=â138; outpatient doctors, nâ=â84; N/A, nâ=â3]; radiologic personnel, nâ=â637 [inpatient doctor, nâ=â303; outpatient doctor, nâ=â50; inpatient technician, nâ=â217; outpatient technician, nâ=â26; N/A, nâ=â41]) were received. Questions of approximation, yes/no questions, and Likert scales were used. RESULTS: During the first/second wave, 70â% (86/123)/43â% (45/104) of inpatient and 26â% (17/66)/10â% (5/52) of outpatient head physicians agreed that they received financial support from the authorities but the majority rated the financial support as insufficient. During the first and second wave, 33â% (8/24) and 80â% (16/20) of outpatient technicians agreed that they were adequately provided with personal protective equipment. The perceived lack of personal protective equipment improved for all participants during the second wave. Inpatient [outpatient] technicians perceived an increased workload in the first and second wave: 72â% (142/198) [79â% (19/24)] and 84â% (146/174) [80â% (16/20)]. CONCLUSION: Technicians seem increasingly negatively affected by the COVID-19 pandemic in Germany. Financial support by the competent authorities seems to be in need of improvement. KEY POINTS: · The accessibility of personal protective equipment resources improved in the second wave.. · In particular, radiology technicians seem increasingly negatively affected by the COVID-19 pandemic.. · Financial and consulting support from the government could be improved.. CITATION FORMAT: · Bernatz S, Afat S, Othman AE etâal. Impact of the COVID-19 Pandemic on Radiology in Inpatient and Outpatient Care in Germany: A Nationwide Survey Regarding the First and Second Wave. Fortschr Röntgenstr 2022; 194: 70â-â82.