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

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.

Department

Medicine

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