학술논문
Reshaping of Italian Echocardiographic Laboratories Activities during the Second Wave of COVID-19 Pandemic and Expectations for the Post-Pandemic Era
Document Type
article
Author
Quirino Ciampi; Francesco Antonini-Canterin; Andrea Barbieri; Agata Barchitta; Frank Benedetto; Alberto Cresti; Sofia Miceli; Ines Monte; Licia Petrella; Giuseppe Trocino; Iolanda Aquila; Giovanni Barbati; Valentina Barletta; Daniele Barone; Monica Beraldi; Gianluigi Bergandi; Giuseppe Bilardo; Giuseppe Boriani; Eduardo Bossone; Amedeo Bongarzoni; Francesca Elisa Bovolato; Francesca Bursi; Valeria Cammalleri; Marco Carbonella; Grazia Casavecchia; Sebastiano Cicco; Giovanni Cioffi; Rosangela Cocchia; Paolo Colonna; Lauro Cortigiani; Umberto Cucchini; Maria Grazia D'Alfonso; Antonello D’Andrea; Luca Dell'Angela; Ilaria Dentamaro; Marcella De Paolis; Paola De Stefanis; Wanda Deste; Maria Di Fulvio; Giovanna Di Giannuario; Daniela Di Lisi; Concetta Di Nora; Iacopo Fabiani; Roberta Esposito; Fabio Fazzari; Luigi Ferrara; Gemma Filice; Davide Forno; Mauro Giorgi; Enrico Giustiniano; Cosimo Angelo Greco; Gian Luca Iannuzzi; Annibale Izzo; Alberto Maria Lanzone; Alessandro Malagoli; Francesca Mantovani; Vincenzo Manuppelli; Simona Mega; Elisa Merli; Margherita Ministeri; Doralisa Morrone; Cosimo Napoletano; Luigi Nunziata; Guido Pastorini; Chiara Pedone; Enrica Petruccelli; Maria Vincenza Polito; Vincenzo Polizzi; Costantina Prota; Fausto Rigo; Dante Eduardo Rivaben; Silvio Saponara; Angela Sciacqua; Chiara Sartori; Virginia Scarabeo; Walter Serra; Sergio Severino; Luciano Spinelli; Gloria Tamborini; Antonio Tota; Bruno Villari; Scipione Carerj; Eugenio Picano; Mauro Pepi; SIECoVId Study Group, on Behalf of the Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI)
Source
Journal of Clinical Medicine, Vol 10, Iss 16, p 3466 (2021)
Subject
Language
English
ISSN
2077-0383
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.