Impact of the first wave of coronavirus disease 2019 (COVID-19) pandemic on the diagnosis of heart disease in the Russian Federation: results from the Russian segment of the IAEA INCAPS COVID study

Aim. To assess the impact of the first wave of coronavirus disease 2019 (COVID-19) pandemic on the diagnosis of heart disease in the Russian Federation.

Material and methods. Fifteen Russian medical centers from 5 cities took part in an online survey organized by the Division of Human Health of the International Atomic Energy Agency (IAEA), containing questions regarding alterations in cardiovascular procedure volumes resulting from COVID-19 in March-April 2020.

Results. A number of outpatients undergoing cardiac diagnostic procedures was noted in 80% of clinics. Cardiovascular procedure volumes in the period from March 2019 to March 2020 in general decreased by 9,5%, and from March 2019 to April 2020, by 56,5%. Stress electrocardiography decreased by 38,4%, stress echocardiography by 72,5%, stress single-photon emission computed tomography by 66,9%, computed tomography angiography by 49,7%, magnetic resonance imaging by 42,7%, invasive coronary angiography by 40,7%. The decrease in diagnostic procedure volumes in selected regions (Tomsk Oblast, Kemerovo Oblast, Tatarstan) was not so pronounced compared to Moscow and St. Petersburg (-20,7%, -75,2%, -93,8% in April 2020, respectively, p<0,001).

Conclusion. The first wave of the COVID-19 pandemic caused a sharp decrease in the number of diagnostic cardiac procedures in Russia. This has potential longterm implications for patients with cardiovascular disease. Understanding these implications can help guide diagnostic strategies during the ongoing COVID-19 pandemic and minimize the future losses.

1. Federal State Statistic Service. (In Russ.) Федеральная служба государственной статистики. https://rosstat.gov.ru

2. Official information about the COVID-19 in Russia. (In Russ.) https://стопкоронавирус.рф

3. Knuuti J, Wijns W, Saraste A, et al., Group E. S.C.S.D. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2019;41(3):407-77. doi:10.1093/eurheartj/ehz425.

4. The European Society for Cardiology. ESC Guidance for the Diagnosis and Management of CV Disease during the COVID-19 Pandemic. https://www.escardio.org/Education/COVID-19-and-Cardiology/ESC-COVID-19-Guidance. (Last update: 10 June 2020)

5. Choi AD, Abbara S, Branch KR, et al. Society of Cardiovascular Computed Tomography guidance for use of cardiac computed tomography amidst the COVID-19 pandemic Endorsed by the American College of Cardiology. J Cardiovasc Comput Tomogr. 2020;14(2):101-4. doi:10.1016/j.jcct.2020.03.002.

6. Skulstad H, Cosyns B, Popescu BA, et al. COVID-19 pandemic and cardiac imaging: EACVI recommendations on precautions, indications, prioritization, and protection for patients and healthcare personnel. Eur Heart J Cardiovasc Imaging. 2020;21(6):592-8. doi:10.1093/ehjci/jeaa072.

7. Sinitsyn VE, Tyurin IE, Mitkov VV. Consensus Guidelines of Russian Society of Radiology (RSR) and Russian Association of Specialists in Ultrasound Diagnostics in Medicine (RASUDM) “Role of Imaging (X-ray, CT and US) in Diagnosis of COVID-19 Pneumonia” (version 2). Journal of radiology and nuclear medicine. 2020;101(2):72-89. (In Russ.) doi:10.20862/0042-4676-2020-101-2-72-89.

8. Einstein AJ, Shaw LJ, Hirschfeld CB, et al. International impact of COVID-19 on the diagnosis of heart disease. J Am Coll Cardiol. 2021;77(2):173-85. doi:10.1016/j.jacc.2020.10.054.

9. Williams MC, Shaw LJ, Hirschfeld C, et al., on behalf of the INCAPS COVID Investigators Group. Impact of COVID-19 on the diagnosis of heart disease in Europe. The European Heart Journal — Cardiovascular Imaging. 2021 (In Press).

10. De Rosa S, Spaccarotella C, Basso C, et al., Societa Italiana di C., the C.C.U.A.i.g. Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era. Eur Heart J. 2020;41(22):2083-8. doi:10.1093/eurheartj/ehaa409.

11. Li X, Guan B, Su T, et al. Impact of cardiovascular disease and cardiac injury on in-hospital mortality in patients with COVID-19: a systematic review and meta-analysis. Heart. 2020;106(15):1142-7. doi:10.1136/heartjnl-2020-317062.

12. Mafham MM, Spata E, Goldacre R, et al. COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England. Lancet. 2020;396(10248):381-9. doi:10.1016/S0140-6736(20)31356-8.

13. Solomon MD, McNulty EJ, Rana JS, et al. The Covid-19 Pandemic and the Incidence of Acute Myocardial Infarction. N Engl J Med. 2020;383(7):691-3. doi:10.1056/NEJMc2015630.

14. Wu J, Mamas MA, Mohamed MO, et al. Place and causes of acute cardiovascular mortality during the COVID-19 pandemic. Heart. 2021;107(2):113-9. doi:10.1136/heartjnl-2020-317912.

15. Nishiga M, Wang DW, Han Y, et al. COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives. Nat Rev Cardiol. 2020;17(9):543-58. doi:10.1038/s41569-020-0413-9.