Abstract
PurposeDuring the first peak of the COVID-19 pandemic, the activity of Emergency Departments worldwide changed dramatically, focusing on diagnosis and care of the Sars-Cov-2 associated disease. These major changes also involved the activity of the Emergency Radiology Department (ERD). This study aimed to analyse the impact of the COVID-19 pandemic on imaging studies, both in terms of the amount, frequency and subspecialty of different imaging modalities requested to the ERD of the Maggiore della Carità Hospital in Novara (Italy).MethodsTo this end, our observational study took into account the imaging studies requested by the emergency department during three-time spans. These were defined as phase 0 (pre-pandemic), phase 1 (pandemic peak with complete lockdown) and phase 2 (post-pandemic peak with partial lifting of restrictive measures), as derived from Italian urgent decrees by the President of the Council of Ministers (DPCM) which established the duration and entity of the lockdown measures throughout the pandemic. The dataset was processed and then compared with Pearson’s chi-squared test.ResultsDuring the pandemic peak, our data showed a significant drop in the total number of studies requested and a significant rise in computed tomography (CT) studies. In particular, a statistically significant increase in chest CT studies was found, probably due to the high sensitivity of this imaging method in identifying pulmonary involvement during respiratory tract infection of possible viral etiology (SARS-Cov-2). Moreover, we observed a statistically significant decrease of X-ray (XR) and ultrasound (US) studies during phase 1 compared to phase 0 and phase 2 probably due to a reduction in the numbers of ER visits for minor traumas given the mobility restrictions and people hesitancy in visiting the ER due to fear of contagion.ConclusionsWe can conclude that the activity of the ERD was heavily impacted by the SARS-Cov-2 pandemic. Further studies will be needed to estimate the impact of the pandemic on public health in terms of excess mortality related to delayed diagnosis and care of non-COVID diseases.
Highlights
Between the end of February and the beginning of March 2020, the Sars-nCov-2 pandemic reshaped the way hospitals and their radiology departments provide for healthcare1 3 Vol.:(0123456789)Emergency Radiology (2021) 28:705–711 main trauma centre in the north-eastern part of the region of Piedmont, and according to its website, visits to its Emergency Department were 71,730 in 2019
The differences observed between the relative frequencies of phase 0 and phase 1 were statistically significant (p < 0.0001) for conventional radiology studies, for computed tomography (CT) scans, for US studies and in terms of studies with findings congruent with the clinician’s query studies
Other types of CT studies showed no significant difference in frequency between phase 0 and phase 1 frequencies values; only a non-significant reduction in head CT scans was identified (n0 = 992 (12.13%) vs n1 = 486 (11.71%))
Summary
Between the end of February and the beginning of March 2020, the Sars-nCov-2 pandemic reshaped the way hospitals and their radiology departments provide for healthcare. Emergency Radiology (2021) 28:705–711 main trauma centre in the north-eastern part of the region of Piedmont, and according to its website (http://www.maggioreosp.novara.it/lospedale-maggiore/chi-siamo/lazienda-di-oggi/), visits to its Emergency Department were 71,730 in 2019. During the COVID-19 pandemic, the whole province of Novara was significantly affected. Until 24/06/2020, the province of Novara had 2780 confirmed COVID-19 cases out of a total of 31,276 cases for the Piedmont region (http://www.salute.gov.it/imgs/C_17_notizie_4933_1_file.pdf). The activity of the whole Radiology department was necessarily reshaped, in line with regional and national provisions, and in the same way as other main hospitals, such as in Milan [3]. Two consultant radiologists and two residents were rostered each shift, the latter reading studies remotely, in order to allow proper distancing
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