Pulmonary embolism during the COVID‐19 pandemic: Decline in diagnostic procedures and incidence at a university hospital

Abstract

Abstract Background The COVID‐19 pandemic has focused medical attention on treating affected patients and protecting others from infection. However, concerns have been raised regarding the pandemic´s impact and associated containment measures (eg curfew, lockdown) on non–coronavirus disease 2019 (COVID‐19)–related acute medical diseases. Objectives To investigate changes in the incidence of pulmonary embolism (PE) during the COVID‐19 pandemic compared to the period before the pandemic and reference periods in previous years. Methods In this single‐center study, we explored all diagnostic imaging tests performed for suspected PE between weeks 1 and 17 of the years 2018, 2019, and 2020. Incidence of PE (ie, primary outcome) was analyzed. Secondary outcomes included number of imaging tests for suspected PE. Results Compared to weeks 1 to 11, 2020, an abrupt decline in PE diagnosis (mean weekly rate, 5.2; 95% confidence interval [CI], 3.8‐6.6 vs 1.8; 95% CI, 0.0‐3.6) and imaging tests (mean weekly rate, 32.5; 95% CI, 27.5‐37.6 vs. 17.3; 95% CI, 11.6‐23.1) was observed from week 12, with beginning of the containment measures and public lockdown in Austria. Compared to weeks 12 to 17 of 2018 and 2019, PE incidence and imaging tests were similarly decreased from 5.3 (95% CI, 3.6‐7.1) to 1.8 (95% CI, 0.0‐3.6) and 31.5 (95% CI, 27.1‐35.9) to 17.3 (95% CI, 11.6‐23.1), respectively. The median simplified pulmonary embolism severity index (sPESI) score of PE patients during the pandemic was higher than in all other PE patients (3; interquartile range, 1‐3 vs 1; interquartile range, 0‐2; P = .002). Conclusion Our study demonstrates that the COVID‐19 pandemic has an impact on non–COVID‐19–related acute diseases as shown by the decline in incidence of PE and imaging procedures for diagnostic workup. Further studies from other hospitals are needed to confirm our findings.

Keywords

• COVID‐19
• diagnostic imaging
• incidence
• pulmonary embolism
• severe acute respiratory syndrome coronavirus 2
• thromboembolism