Longitudinal study of interventional radiology activity in a large metropolitan Italian tertiary care hospital: how the COVID-19 pandemic emergency has changed our activity.
Aged
Betacoronavirus
COVID-19
Coronavirus Infections
/ diagnosis
Emergency Service, Hospital
/ statistics & numerical data
Female
Hospitalization
/ trends
Humans
Italy
/ epidemiology
Longitudinal Studies
Male
Middle Aged
Pandemics
Pneumonia, Viral
/ diagnosis
Radiography
/ methods
Radiology, Interventional
/ methods
Retrospective Studies
SARS-CoV-2
Tertiary Care Centers
/ statistics & numerical data
Infections
Interventional radiology
Neoplasms
Safety
Virus diseases
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
21
05
2020
accepted:
17
06
2020
revised:
02
06
2020
pubmed:
2
7
2020
medline:
11
11
2020
entrez:
2
7
2020
Statut:
ppublish
Résumé
To retrospectively analyze interventional radiology (IR) activity changes in the COVID-19 era and to describe how to safely and effectively reorganize IR activity. All IR procedures performed between January 30 and April 8, 2020 (COVID-era group) and the same 2019 period (non-COVID-era group) were retrospectively included and compared. A sub-analysis for the lockdown period (LDP: 11 March-8 April) was also conducted. Demographic, hospitalization, clinical, and procedural data were obtained for both groups and statistically compared with univariable analysis. A total of 1496 procedures (non-COVID era, 825; COVID era, 671) performed in 1226 patients (64.9 ± 15.1 years, 618 women) were included. The number of procedures decreased by 18.6% between 2019 and 2020 (825 vs 671, p < .001), with a reduction by 48.2% in LDP (188 vs 363, p < .0001). In the LDP COVID era, bedside procedures were preferred (p = .013), with an increase in procedures from the intensive care unit compared with the emergency department and outpatients (p = .048), and an increased activity for oncological patients (p = .003). No incidents of cross-infection of non-infected from infected patients and no evidence of COVID-19 infection of healthcare workers in the IR service was registered. Coronavirus disease outbreak changed the interventional radiology activity with an overall reduction in the number of procedures. However, this study confirms that interventional radiology continuum of care can be safely performed also during the pandemic, following defined measures and protocols, taking care of all patients. • Coronavirus disease pandemic determined a reduction of interventional radiology activity as compared to the same period of the previous year. • Interventional radiology procedures for life-threatening conditions and non-deferrable oncologic treatments were prioritized as opposed to elective procedures. • Strict adoption of safe procedures allowed us to have until now no incidents of cross-infection of non-infected from infected patients and no evidence of COVID-19 infection of HCWs in the IR service.
Identifiants
pubmed: 32607633
doi: 10.1007/s00330-020-07041-y
pii: 10.1007/s00330-020-07041-y
pmc: PMC7326392
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
6940-6949Références
World Health Organization (2020) WHO statement on the Second Meeting of the International Health Regulations (2005) emergency committee regarding the outbreak of novel coronavirus (2019-nCoV). World Health Organization, Geneva.. Available via https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov ). Accessed 10 Apr 2020
World Health Organization (2020) WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. World Health Organization, Geneva. Available via https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19%2D%2D-11-march-2020 . Accessed 10 Apr 2020
World Health Organization (2020) Global surveillance for human infection with coronavirus disease (COVID-2019). Jan 31, 2020. World Health Organization, Geneva. Available via https://www.who.int/publications-detail/global-surveillance-for-human-infection-with-novel-coronavirus-(2019-ncov ). Accessed 10 Apr 2020
Spina S, Marrazzo F, Migliari M, Stucchi R, Sforza A, Fumagalli R (2020) The response of Milan’s emergency medical system to the COVID-19 outbreak in Italy. Lancet 395:e49–e50
doi: 10.1016/S0140-6736(20)30493-1
pubmed: 32119824
pmcid: 32119824
Stefanini GG, Azzolini E, Condorelli G (2020) Critical organizational issues for cardiologists in the COVID-19 outbreak: a frontline experience from Milan, Italy. Circulation 141:1597–1599
doi: 10.1161/CIRCULATIONAHA.120.047070
pubmed: 32207994
pmcid: 32207994
Remuzzi A, Remuzzi G (2020) COVID-19 and Italy: what next? Lancet 395:1225–1228
doi: 10.1016/S0140-6736(20)30627-9
pubmed: 32178769
pmcid: 32178769
Grasselli G, Pesenti A, Cecconi M (2020) Critical care utilization for the COVID-19 outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response. JAMA. https://doi.org/10.1001/jama.2020.4031
Gazzetta Ufficiale della Repubblica Italiana (2020) DPCM 09 Marzo 2020 “Ulteriori disposizioni attuative del decreto-legge 23 febbraio 2020, n. 6, recante misure urgenti in materia di contenimento e gestione dell'emergenza epidemiologica da COVID-19, applicabili sull'intero territorio nazionale” (20A01605) (GU Serie Generale n.62 del 09-03-2020) DPCM 09.03.2020. Gazzetta Ufficiale della Repubblica Italiana, Rome. Available via https://www.gazzettaufficiale.it/atto/serie_generale/caricaDettaglioAtto/originario?atto.dataPubblicazioneGazzetta=2020-03-09&atto.codiceRedazionale=20A01558&elenco30giorni=false . Accessed April 10, 2020
Gazzetta Ufficiale della Repubblica Italiana (2020) DPCM 22 Marzo 2020 “Ulteriori disposizioni attuative del decreto-legge 23 febbraio 2020, n. 6, recante misure urgenti in materia di contenimento e gestione dell'emergenza epidemiologica da COVID-19, applicabili sull'intero territorio nazionale” (20A01605) (GU Serie Generale n.76 del 22-03-2020) DPCM 22.03.2020. Gazzetta Ufficiale della Repubblica Italiana, Rome. Available via https://www.gazzettaufficiale.it/atto/serie_generale/caricaDettaglioAtto/originario?atto.dataPubblicazioneGazzetta=2020-03-22&atto.codiceRedazionale=20A01807&elenco30giorni=false . Accessed 10 Apr 2020
Signorelli C, Scognamiglio T, Odone A (2020) COVID-19 in Italy: impact of containment measures and prevalence estimates of infection in the general population. Acta Biomed 91:175–179
pubmed: 32275287
Zhou F, Yu T, Du R et al (2020) Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 395:1054–1062
doi: 10.1016/S0140-6736(20)30566-3
pubmed: 32171076
pmcid: 32171076
Carenzo L, Costantini E, Greco M et al (2020) Hospital surge capacity in a tertiary emergency referral centre during the COVID-19 outbreak in Italy. Anaesthesia. https://doi.org/10.1111/anae.15072
Boccia S, Ricciardi W, Ioannidis JPA (2020) What other countries can learn from Italy during the COVID-19 pandemic. JAMA Intern Med. https://doi.org/10.1001/jamainternmed.2020.1447
Charalel RA, McGinty G, Brant-Zawadzki M et al (2015) Interventional radiology delivers high-value health care and is an Imaging 3.0 vanguard. J Am Coll Radiol 12:501–506
doi: 10.1016/j.jacr.2014.10.024
pubmed: 25703699
Chandy PE, Nasir MU, Srinivasan S, Klass D, Nicolaou S, Babu SB (2020) Interventional radiology and COVID-19: evidence-based measures to limit transmission. Diagn Interv Radiol 26:236–240
doi: 10.5152/dir.2020.20166
pubmed: 32229433
pmcid: 7239364
Zhu HD, Zeng CH, Lu J, Teng GJ (2020) COVID-19: what should interventional radiologists know and what can they do? J Vasc Interv Radiol. https://doi.org/10.1016/j.jvir.2020.03.022
Ierardi AM, Wood BJ, Gaudino C et al (2020) How to handle a COVID-19 patient in the angiographic suite. Cardiovasc Intervent Radiol 43:820–826
doi: 10.1007/s00270-020-02476-8
pubmed: 32277272
pmcid: 32277272
Hoe Gan W, Wah Lim J, Koh D (2020) Preventing intra-hospital infection and transmission of COVID-19 in healthcare workers. Saf Health Work. https://doi.org/10.1016/j.shaw.2020.03.001
Keeley AJ, Evans C, Colton H et al (2020) Roll-out of SARS-CoV-2 testing for healthcare workers at a large NHS Foundation Trust in the United Kingdom, March 2020. Euro Surveill 25:2000433
doi: 10.2807/1560-7917.ES.2020.25.14.2000433
Kandel N, Chungong S, Omaar A, Xing J (2020) Health security capacities in the context of COVID-19 outbreak: an analysis of International Health Regulations annual report data from 182 countries. Lancet 395:1047–1053
doi: 10.1016/S0140-6736(20)30553-5
pubmed: 7271261
pmcid: 7271261
Gogna A, Punamiya S, Gopinathan A et al (2020) Preparing IR for COVID-19: the Singapore experience. J Vasc Interv Radiol. https://doi.org/10.1016/j.jvir.2020.03.021
Society of Interventional Radiology (2020) COVID-19 case classification. Society of Interventional Radiology, Fairfax (VA). Available via https://www.sirweb.org/practice-resources/toolkits/covid-19-toolkit/covid-19-case-classification . Accessed 10 Apr 2020
Da Zhuang K, Tan BS, Tan BH, Too CW, Tay KH (2020) Old threat, new enemy: is your interventional radiology service ready for the coronavirus disease 2019? Cardiovasc Intervent Radiol 43:665–666
doi: 10.1007/s00270-020-02440-6
pubmed: 32103304
Pedicelli A, Valente I, Pilato F, Distefano M, Colosimo C (2020) Stroke priorities during COVID-19 outbreak: acting both fast and safe. J Stroke Cerebrovasc Dis. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104922
Ma QX, Shan H, Zhang HL, Li GM, Yang RM, Chen JM (2020) Potential utilities of mask-wearing and instant hand hygiene for fighting SARS-CoV-2. J Med Virol. https://doi.org/10.1002/jmv.25805
Nicola M, O'Neill N, Sohrabi C, Khan M, Agha M, Agha R (2020) Evidence based management guideline for the COVID-19 pandemic - review article. Int J Surg 77:206–216
doi: 10.1016/j.ijsu.2020.04.001
pubmed: 32289472
pmcid: 7151371
World Health Organization (2020) Rational use of personal protective equipment for coronavirus disease (COVID - 19) World Health Organization – Interim Guidance – 27 February 2020. World Health Organization, Geneva. Available via https://apps.who.int/iris/bitstream/handle/10665/331215/WHO-2019-nCov-IPCPPE_use-2020.1-eng.pdf . Accessed 10 Apr 2020
Roda WC, Varughese MB, Han D, Li MY (2020) Why is it difficult to accurately predict the COVID-19 epidemic? Infect Dis Model 5:271–281
pubmed: 32289100
pmcid: 32289100