Impact of the Covid-19 pandemic on the care of patients with chronic arterial disease. A nuclear medicine physician's perspective

ABSTRACT

Aim/Introduction: The health reorganisation measures, imposed after the serious health emergency resulting from the SARS-CoV-2 pandemic, may have had a negative impact on the follow-up of patients with chronic pathologies. Our intention was to assess their repercussion in our environment, observing what happened in patients with a history of coronary artery disease (CAD) in terms of accesibility and diagnostic performance. Material(s) and Method(s) Retrospective observational study of 756 patients consecutively referred to our Department for myocardial perfusion (MP) studies. Two time groups were established (G1 and G2), both lasting one year, taking as a cut-off point the establishment of the state of health alarm in our country. From the total number of records reviewed 131 patients were selected (mean age 65.74 > 11.03 SD), all with a history of CAD prior to the performance of the MP (G1 56.49%;G2 43.52%). Delay times between test request and test performance were obtained G1 (17.89 days > 9.85 SD), G2 (16.32 > 20.81 SD) and study results based on two variables, stability or inducible ischaemia. Result(s) In the pre-alarm period (G1) there were more requests for PM studies than in G2 (419 vs 337), with a similar percentage of CAD to total patients (17.66% vs 16.91%). Typical clinical presentation, following the traditional clinical classification, predominated and was statistically significant (p=0.001) for this first group (78.38% vs 52.63%). However, G1 showed a lower number of positive PM results than G2 (37.83% vs 43.85%), and the percentage of total catheterisations performed was also lower (57.14% vs 68%). In relation to the mean delay time between positive PM and catheterisation, a shorter duration was observed for G1 (65.64 days > 46.19 SD) than for G2 (95.41 days > 71.73 SD). No statistically significant differences (p=0.768) were found between the mean ages of patients in the two groups. Conclusion(s) In our health care system, the follow-up of patients with CAD after the establishment of the alarm status was affected by a lower percentage of patients referred to our Department and a longer delay between positive PM and catheterisation. In this period, it is remarkable the higher number of positive PM in patients without typical clinical features. We are unaware of the possible involvement of covid-19 in this situation, currently being investigated by our working group.