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Bremner L, Vitola J, Cerci R, Campisi R, Araujo Ríos R, Massardo T, Gutierrez-Villamil C, Solis F, Peix A, Speckter H, Sanchez Velez M, Flores AC, Madu E, Alexánderson-Rosas E, Ortellado J, Morales R, Mut F, Vera L, Hirschfeld CB, Shaw LJ, Williams MC, Villines TC, Better N, Dorbala S, Karthikeyan G, Malkovskiy E, Cohen YA, Randazzo M, Pascual TN, Pynda Y, Dondi M, Paez D, Einstein AJ. Cardiovascular testing recovery in Latin America one year into the COVID-19 pandemic: An analysis of data from an international longitudinal survey. IJC HEART & VASCULATURE 2024; 52:101404. [PMID: 38590383 PMCID: PMC11000160 DOI: 10.1016/j.ijcha.2024.101404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/23/2024] [Accepted: 04/01/2024] [Indexed: 04/10/2024]
Abstract
Background The COVID-19 pandemic disproportionately impacted Latin America (LATAM), significantly disrupting cardiovascular testing. This study evaluated cardiac procedure recovery in LATAM one year after the outbreak. Methods The International Atomic Energy Agency (IAEA) surveyed 669 centers in 107 countries worldwide, including 135 facilities in 19 LATAM countries, to assess cardiovascular procedure volumes in March 2019, April 2020, and April 2021, and changes in center practices and staffing conditions one year into the COVID-19 pandemic. Findings LATAM centers reported a 21 % decrease in procedure volumes in April 2021 from pre-pandemic-baseline, vs. a 0 % change in the rest of the world (RoW), and greater volume reductions for almost all procedure types. Centers in Central America and Mexico reported the largest procedure reductions (47 % reduction) compared to the Caribbean (15 %), and South America (14 %, p = 0.01), and this LATAM region was a significant predictor of lower procedure recovery in multivariable regression. More LATAM centers reported reduced salaries and increased layoffs of clinical staff compared to RoW, and LATAM respondents estimated that half of physician and non-physician staff experienced excess psychological stress related to the pandemic, compared to 25 % and 30 % in RoW (p < 0.001). Conclusions Cardiovascular testing recovery in LATAM trailed behind RoW for most procedure types, with centers in Central America and Mexico reporting the greatest volume reductions. This study found lasting impacts of COVID-19 on cardiovascular care in LATAM and the need for mental health support for LATAM healthcare workers in current and future pandemics.
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Affiliation(s)
- Luca Bremner
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | | | | | - Roxana Campisi
- Diagnóstico Maipú and Instituto Argentino de Diagnóstico Y Tratamiento S.A., Buenos Aires, Argentina
| | | | | | | | - Felix Solis
- Hospital Escalante Pradilla, Perez Zeledon, Costa Rica
| | - Amalia Peix
- Institute of Cardiology and Cardiovascular Surgery, La Habana, Cuba
| | | | - Mayra Sanchez Velez
- Sociedad Ecuatoriana de Cardiología Y a La Sociedad Española de Imagen Cardíaca, Ecuador
| | | | - Ernest Madu
- Heart Institute of the Caribbean and HIC Heart Hospital, Kingston, Jamaica
| | | | | | - Rosanna Morales
- Departamento de Medicina Nuclear, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | | | | | - Cole B. Hirschfeld
- Division of Cardiology, Weill Cornell Medicine and NewYork-Presbyterian Hospital, New York, NY, USA
| | - Leslee J. Shaw
- Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical Center, New York, NY, USA
| | | | - Todd C. Villines
- Division of Cardiovascular Medicine, Department of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Nathan Better
- Cabrini Health, Royal Melbourne Hospital, Monash University and University of Melbourne, Melbourne, Australia, Melbourne, Australia
| | - Sharmila Dorbala
- Departments of Medicine and Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Ganesan Karthikeyan
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Eli Malkovskiy
- Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, New York, NY, USA
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Yosef A. Cohen
- Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Children's Hospital at Montefiore, New York, NY, USA
| | - Michael Randazzo
- Section of Cardiology, University of Chicago Medical Center, Chicago, IL, USA
| | | | - Yaroslav Pynda
- Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Maurizio Dondi
- Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Diana Paez
- Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Andrew J. Einstein
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, New York, NY, USA
- Department of Radiology, Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY, USA
| | - INCAPS COVID
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Quanta Diagnostico, Curitiba, Brazil
- Diagnóstico Maipú and Instituto Argentino de Diagnóstico Y Tratamiento S.A., Buenos Aires, Argentina
- Instituto de Medicina Nuclear, Sucre, Bolivia
- Hospital Clinico Universidad de Chile, Santiago, Chile
- Fundacion Cardioinfantil, Instituto de Cardiologia, Bogota, Colombia
- Hospital Escalante Pradilla, Perez Zeledon, Costa Rica
- Institute of Cardiology and Cardiovascular Surgery, La Habana, Cuba
- Cedimat, Santo Domingo, Dominican Republic
- Sociedad Ecuatoriana de Cardiología Y a La Sociedad Española de Imagen Cardíaca, Ecuador
- Clinica de Radiologia Brito Mejia Peña, San Salvador, El Salvador
- Heart Institute of the Caribbean and HIC Heart Hospital, Kingston, Jamaica
- Instituto Nacional de Cardiologia Ignacio Chavez, Ciudad de Mexico, Mexico
- Central Hospital, Social Institute, Asunción, Paraguay
- Departamento de Medicina Nuclear, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
- Italian Hospital, Montevideo, Uruguay
- Urologico San Roman, Caracas, Venezuela
- Division of Cardiology, Weill Cornell Medicine and NewYork-Presbyterian Hospital, New York, NY, USA
- Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical Center, New York, NY, USA
- BHF Centre for Cardiovascular Science, University of Edinburgh, United Kingdom
- Division of Cardiovascular Medicine, Department of Medicine, University of Virginia, Charlottesville, VA, USA
- Cabrini Health, Royal Melbourne Hospital, Monash University and University of Melbourne, Melbourne, Australia, Melbourne, Australia
- Departments of Medicine and Radiology, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
- Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, New York, NY, USA
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Children's Hospital at Montefiore, New York, NY, USA
- Section of Cardiology, University of Chicago Medical Center, Chicago, IL, USA
- Philippine Nuclear Research Institute, Quezon City, Philippines
- Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
- Department of Radiology, Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY, USA
| | - 2
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Quanta Diagnostico, Curitiba, Brazil
- Diagnóstico Maipú and Instituto Argentino de Diagnóstico Y Tratamiento S.A., Buenos Aires, Argentina
- Instituto de Medicina Nuclear, Sucre, Bolivia
- Hospital Clinico Universidad de Chile, Santiago, Chile
- Fundacion Cardioinfantil, Instituto de Cardiologia, Bogota, Colombia
- Hospital Escalante Pradilla, Perez Zeledon, Costa Rica
- Institute of Cardiology and Cardiovascular Surgery, La Habana, Cuba
- Cedimat, Santo Domingo, Dominican Republic
- Sociedad Ecuatoriana de Cardiología Y a La Sociedad Española de Imagen Cardíaca, Ecuador
- Clinica de Radiologia Brito Mejia Peña, San Salvador, El Salvador
- Heart Institute of the Caribbean and HIC Heart Hospital, Kingston, Jamaica
- Instituto Nacional de Cardiologia Ignacio Chavez, Ciudad de Mexico, Mexico
- Central Hospital, Social Institute, Asunción, Paraguay
- Departamento de Medicina Nuclear, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
- Italian Hospital, Montevideo, Uruguay
- Urologico San Roman, Caracas, Venezuela
- Division of Cardiology, Weill Cornell Medicine and NewYork-Presbyterian Hospital, New York, NY, USA
- Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical Center, New York, NY, USA
- BHF Centre for Cardiovascular Science, University of Edinburgh, United Kingdom
- Division of Cardiovascular Medicine, Department of Medicine, University of Virginia, Charlottesville, VA, USA
- Cabrini Health, Royal Melbourne Hospital, Monash University and University of Melbourne, Melbourne, Australia, Melbourne, Australia
- Departments of Medicine and Radiology, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
- Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, New York, NY, USA
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Children's Hospital at Montefiore, New York, NY, USA
- Section of Cardiology, University of Chicago Medical Center, Chicago, IL, USA
- Philippine Nuclear Research Institute, Quezon City, Philippines
- Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
- Department of Radiology, Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY, USA
| | - Investigators Group
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Quanta Diagnostico, Curitiba, Brazil
- Diagnóstico Maipú and Instituto Argentino de Diagnóstico Y Tratamiento S.A., Buenos Aires, Argentina
- Instituto de Medicina Nuclear, Sucre, Bolivia
- Hospital Clinico Universidad de Chile, Santiago, Chile
- Fundacion Cardioinfantil, Instituto de Cardiologia, Bogota, Colombia
- Hospital Escalante Pradilla, Perez Zeledon, Costa Rica
- Institute of Cardiology and Cardiovascular Surgery, La Habana, Cuba
- Cedimat, Santo Domingo, Dominican Republic
- Sociedad Ecuatoriana de Cardiología Y a La Sociedad Española de Imagen Cardíaca, Ecuador
- Clinica de Radiologia Brito Mejia Peña, San Salvador, El Salvador
- Heart Institute of the Caribbean and HIC Heart Hospital, Kingston, Jamaica
- Instituto Nacional de Cardiologia Ignacio Chavez, Ciudad de Mexico, Mexico
- Central Hospital, Social Institute, Asunción, Paraguay
- Departamento de Medicina Nuclear, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
- Italian Hospital, Montevideo, Uruguay
- Urologico San Roman, Caracas, Venezuela
- Division of Cardiology, Weill Cornell Medicine and NewYork-Presbyterian Hospital, New York, NY, USA
- Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical Center, New York, NY, USA
- BHF Centre for Cardiovascular Science, University of Edinburgh, United Kingdom
- Division of Cardiovascular Medicine, Department of Medicine, University of Virginia, Charlottesville, VA, USA
- Cabrini Health, Royal Melbourne Hospital, Monash University and University of Melbourne, Melbourne, Australia, Melbourne, Australia
- Departments of Medicine and Radiology, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
- Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, New York, NY, USA
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Children's Hospital at Montefiore, New York, NY, USA
- Section of Cardiology, University of Chicago Medical Center, Chicago, IL, USA
- Philippine Nuclear Research Institute, Quezon City, Philippines
- Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
- Department of Radiology, Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY, USA
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