Journal of Clinical Medicine (Aug 2021)

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 Bongarzoni,
  • Francesca 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,
  • SIECoVId Study Group, on Behalf of the Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI)

DOI
https://doi.org/10.3390/jcm10163466
Journal volume & issue
Vol. 10, no. 16
p. 3466

Abstract

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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 p 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.

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