Recovery of cardiovascular testing in Asia during the COVID-19 pandemic: findings from the INCAPS COVID 2 study

Authors

• Kathy Z. Dai, Medicine, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
• Luca Bremner, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
• Yosef Cohen, Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
• Ganesan Karthikeyan, Cardiology, All India Institute of Medical Sciences, New Delhi, India.
• Thomas Nb Pascual, Philippine Nuclear Research Institute, Quezon City, Philippines.
• Bin Lu, Fuwai Hospital, Beijing, China.
• Amjed Albadr, Oncology, Al-Amal National Hospital, Baghdad, Iraq.
• Hee-Seung Henry Bom, Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Hwasun-gun, Korea (the Republic of).
• Tairkhan Dautov, National Research Cardiac Surgery Center, Astana, Kazakhstan.
• Shazia Fatima, Pakistan Atomic Energy Commission, Islamabad, Pakistan.
• Mohamad Haidar, American University of Beirut Medical Center, Beirut, Lebanon.
• Nobuo Iguchi, Sakakibara Heart Institute, Fuchu, Japan.
• Felix Yj Kang, National Heart Centre, Singapore.
• Benjapa Khiewvan, Department of Radiology, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand.
• Damayanthi Nanayakkara, Nuclear Medicine Unit, University of Peradeniya Faculty of Medicine, Peradeniya, Sri Lanka.
• Phuoc Minh Nguyen, Department of Nuclear Medicine, Chợ Rẫy Hospital, Ho Chi Minh, Vietnam.
• Chetan Patel, All India Institute of Medical Sciences, New Delhi, India.
• Gulnora Rozikhodjaeva, Central Clinical Hospital No. 1 of the Main Medical Directorate at the Republic of Uzbekistan Administration, Tashkent, Uzbekistan.
• Nathan Better, Cabrini Health, Malvern, Victoria, Australia.
• Rodrigo J. Cerci, Research and Innovation, Quanta Diagnostico, Curitiba, Brazil.
• Sharmila Dorbala, Harvard Medical School, Boston, Massachusetts, USA.
• Leslee J. Shaw, Blavatnik Family Women's Health Research Institute, Mount Sinai Medical Center, New York, New York, USA.
• Todd C. Villines, University of Virginia, Charlottesville, Virginia, USA.
• João V. Vitola, Quanta Diagnóstico por Imagem, Curitiba, Brazil.
• Michelle C. Williams, Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK.
• Andrew D. Choi, Department of Medicine, Division of Cardiology, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
• Eli Malkovskiy, Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
• Michael Randazzo, Section of Cardiology, The University of Chicago Medical Center, Chicago, Illinois, USA.
• Francesco Gianmarile, International Atomic Energy Agency, Vienna, Austria.
• Yaroslav Pynda, Division of Human Health, Department of Nuclear Sciences and Applications, IAEA, Vienna, Austria.
• Maurizio Dondi, Division of Human Health, Department of Nuclear Sciences and Applications, IAEA, Vienna, Austria.
• Diana Paez, International Atomic Energy Agency, Vienna, Austria.

Document Type

Journal Article

Publication Date

2-27-2025

Journal

Open heart

Volume

12

Issue

1

DOI

10.1136/openhrt-2024-002935

Keywords

COVID-19; Echocardiography; Global Health

Abstract

BACKGROUND: Understanding pandemic-related reductions and subsequent recovery of cardiovascular testing in Asia is important for guiding regional public health efforts. OBJECTIVES: This study sought to evaluate the recovery of cardiovascular testing in Asia 1 year into the COVID-19 pandemic. METHODS: In this subanalysis of a worldwide survey on the impact of COVID-19 on cardiovascular diagnostic care in April 2020 and April 2021, recovery of testing volume in Asia was compared among subregions, World Bank income groups and imaging modalities. RESULTS: Of 669 sites worldwide, 164 sites were in 33 Asian countries. Cardiovascular testing volumes in Asia decreased by 53% from March 2019 to April 2020, then recovered 96% of this decrease by April 2021, compared with 98% recovery in the rest of the world. Eastern Asia and Western and Central Asia reported recovery rates of 123% and 110%, compared with 50% and 80% recovery in Southern and South-eastern Asia. Testing volumes among high-income and upper-middle-income Asian countries recovered to 117% and 121% but remained depressed at 49% and 14% recovery in lower-middle and low-income countries, respectively. Stress ECG, stress echo and stress positron emission tomography studies experienced median reductions of 48%, 35% and 57% in testing volume between March 2019 and April 2021, while volumes of coronary artery calcium, coronary CT angiography and cardiac MR remained stable during this period. CONCLUSIONS: The recovery of cardiovascular testing in Asia 1 year into the COVID-19 pandemic lagged in the Southern and South-eastern subregions, as well as in lower-income countries. Recovery favoured advanced cardiac imaging modalities over standard stress testing modalities.

APA Citation

Dai, Kathy Z.; Bremner, Luca; Cohen, Yosef; Karthikeyan, Ganesan; Pascual, Thomas Nb; Lu, Bin; Albadr, Amjed; Bom, Hee-Seung Henry; Dautov, Tairkhan; Fatima, Shazia; Haidar, Mohamad; Iguchi, Nobuo; Kang, Felix Yj; Khiewvan, Benjapa; Nanayakkara, Damayanthi; Nguyen, Phuoc Minh; Patel, Chetan; Rozikhodjaeva, Gulnora; Better, Nathan; Cerci, Rodrigo J.; Dorbala, Sharmila; Shaw, Leslee J.; Villines, Todd C.; Vitola, João V.; Williams, Michelle C.; Choi, Andrew D.; Malkovskiy, Eli; Randazzo, Michael; Gianmarile, Francesco; Pynda, Yaroslav; Dondi, Maurizio; and Paez, Diana, "Recovery of cardiovascular testing in Asia during the COVID-19 pandemic: findings from the INCAPS COVID 2 study" (2025). GW Authored Works. Paper 6515.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/6515

Department

Medicine