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 < 0.001). On average, there was a significant increase in the outpatient waiting list for elective echocardiographic exams (from 32.0 ± 28.1 to 45.5 ± 44.9 days, +41%, p < 0.001), with a reduction of in-hospital waiting list (2.9 ± 2.4 to 2.4 ± 2.0 days, −17%, 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.

Reshaping of italian echocardiographic laboratories activities during the second wave of covid-19 pandemic and expectations for the post-pandemic era / Ciampi, Q.; Antonini-Canterin, F.; Barbieri, A.; Barchitta, A.; Benedetto, F.; Cresti, A.; Miceli, S.; Monte, I.; Petrella, L.; Trocino, G.; Aquila, I.; Barbati, G.; Barletta, V.; Barone, D.; Beraldi, M.; Bergandi, G.; Bilardo, G.; Boriani, G.; Bossone, E.; Bongarzoni, A.; Bovolato, F. E.; Bursi, F.; Cammalleri, V.; Carbonella, M.; Casavecchia, G.; Cicco, S.; Cioffi, G.; Cocchia, R.; Colonna, P.; Cortigiani, L.; Cucchini, U.; D'Alfonso, M. G.; D'Andrea, A.; Dell'Angela, L.; Dentamaro, I.; De Paolis, M.; De Stefanis, P.; Deste, W.; Di Fulvio, M.; Di Giannuario, G.; Di Lisi, D.; Di Nora, C.; Fabiani, I.; Esposito, R.; Fazzari, F.; Ferrara, L.; Filice, G.; Forno, D.; Giorgi, M.; Giustiniano, E.; Greco, C. A.; Iannuzzi, G. L.; Izzo, A.; Lanzone, A. M.; Malagoli, A.; Mantovani, F.; Manuppelli, V.; Mega, S.; Merli, E.; Ministeri, M.; Morrone, D.; Napoletano, C.; Nunziata, L.; Pastorini, G.; Pedone, C.; Petruccelli, E.; Polito, M. V.; Polizzi, V.; Prota, C.; Rigo, F.; Rivaben, D. E.; Saponara, S.; Sciacqua, A.; Sartori, C.; Scarabeo, V.; Serra, W.; Severino, S.; Spinelli, L.; Tamborini, G.; Tota, A.; Villari, B.; Carerj, S.; Picano, E.; Pepi, M.. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 10:16(2021), pp. N/A-N/A. [10.3390/jcm10163466]

Reshaping of italian echocardiographic laboratories activities during the second wave of covid-19 pandemic and expectations for the post-pandemic era

Boriani G.;Fabiani I.;
2021

Abstract

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 < 0.001). On average, there was a significant increase in the outpatient waiting list for elective echocardiographic exams (from 32.0 ± 28.1 to 45.5 ± 44.9 days, +41%, p < 0.001), with a reduction of in-hospital waiting list (2.9 ± 2.4 to 2.4 ± 2.0 days, −17%, 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.
2021
10
16
N/A
N/A
Reshaping of italian echocardiographic laboratories activities during the second wave of covid-19 pandemic and expectations for the post-pandemic era / Ciampi, Q.; Antonini-Canterin, F.; Barbieri, A.; Barchitta, A.; Benedetto, F.; Cresti, A.; Miceli, S.; Monte, I.; Petrella, L.; Trocino, G.; Aquila, I.; Barbati, G.; Barletta, V.; Barone, D.; Beraldi, M.; Bergandi, G.; Bilardo, G.; Boriani, G.; Bossone, E.; Bongarzoni, A.; Bovolato, F. E.; Bursi, F.; Cammalleri, V.; Carbonella, M.; Casavecchia, G.; Cicco, S.; Cioffi, G.; Cocchia, R.; Colonna, P.; Cortigiani, L.; Cucchini, U.; D'Alfonso, M. G.; D'Andrea, A.; Dell'Angela, L.; Dentamaro, I.; De Paolis, M.; De Stefanis, P.; Deste, W.; Di Fulvio, M.; Di Giannuario, G.; Di Lisi, D.; Di Nora, C.; Fabiani, I.; Esposito, R.; Fazzari, F.; Ferrara, L.; Filice, G.; Forno, D.; Giorgi, M.; Giustiniano, E.; Greco, C. A.; Iannuzzi, G. L.; Izzo, A.; Lanzone, A. M.; Malagoli, A.; Mantovani, F.; Manuppelli, V.; Mega, S.; Merli, E.; Ministeri, M.; Morrone, D.; Napoletano, C.; Nunziata, L.; Pastorini, G.; Pedone, C.; Petruccelli, E.; Polito, M. V.; Polizzi, V.; Prota, C.; Rigo, F.; Rivaben, D. E.; Saponara, S.; Sciacqua, A.; Sartori, C.; Scarabeo, V.; Serra, W.; Severino, S.; Spinelli, L.; Tamborini, G.; Tota, A.; Villari, B.; Carerj, S.; Picano, E.; Pepi, M.. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 10:16(2021), pp. N/A-N/A. [10.3390/jcm10163466]
Ciampi, Q.; Antonini-Canterin, F.; Barbieri, A.; Barchitta, A.; Benedetto, F.; Cresti, A.; Miceli, S.; Monte, I.; Petrella, L.; Trocino, G.; Aquila, I.; Barbati, G.; Barletta, V.; Barone, D.; Beraldi, M.; Bergandi, G.; Bilardo, G.; Boriani, G.; Bossone, E.; Bongarzoni, A.; Bovolato, F. E.; Bursi, F.; Cammalleri, V.; Carbonella, M.; Casavecchia, G.; Cicco, S.; Cioffi, G.; Cocchia, R.; Colonna, P.; Cortigiani, L.; Cucchini, U.; D'Alfonso, M. G.; D'Andrea, A.; Dell'Angela, L.; Dentamaro, I.; De Paolis, M.; De Stefanis, P.; Deste, W.; Di Fulvio, M.; Di Giannuario, G.; Di Lisi, D.; Di Nora, C.; Fabiani, I.; Esposito, R.; Fazzari, F.; Ferrara, L.; Filice, G.; Forno, D.; Giorgi, M.; Giustiniano, E.; Greco, C. A.; Iannuzzi, G. L.; Izzo, A.; Lanzone, A. M.; Malagoli, A.; Mantovani, F.; Manuppelli, V.; Mega, S.; Merli, E.; Ministeri, M.; Morrone, D.; Napoletano, C.; Nunziata, L.; Pastorini, G.; Pedone, C.; Petruccelli, E.; Polito, M. V.; Polizzi, V.; Prota, C.; Rigo, F.; Rivaben, D. E.; Saponara, S.; Sciacqua, A.; Sartori, C.; Scarabeo, V.; Serra, W.; Severino, S.; Spinelli, L.; Tamborini, G.; Tota, A.; Villari, B.; Carerj, S.; Picano, E.; Pepi, M.
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