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

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 BongarzoniFrancesca 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

Research output: Contribution to journalArticlepeer-review

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.
Original languageEnglish
JournalJournal of Clinical Medicine
Volume10
Issue number16
DOIs
Publication statusPublished - Aug 2 2021

Keywords

  • COVID-19
  • Lung ultrasound
  • Point-of-care cardiac ultrasound

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