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2020 ; 4
(5
): 835-841
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Pulmonary embolism during the COVID-19 pandemic: Decline in diagnostic procedures
and incidence at a university hospital
#MMPMID32685892
Nopp S
; Janata-Schwatczek K
; Prosch H
; Shulym I
; Königsbrügge O
; Pabinger I
; Ay C
Res Pract Thromb Haemost
2020[Jul]; 4
(5
): 835-841
PMID32685892
show ga
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.