Background The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. Objectives The study sought to assess COVID-19’s impact on global cardiovascular diagnostic procedural volumes and safety practices. Methods The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. Results Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoracic echocardiography decreased by 59%, transesophageal echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p < 0.001 for each procedure). In multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower–middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth. Conclusions COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world’s economically challenged. Further study of cardiovascular outcomes and COVID-19–related changes in care delivery is warranted.

中文翻译：

---

COVID-19 对心脏病诊断的国际影响

背景 2019 年冠状病毒病（COVID-19）大流行对非传染性疾病的诊断和治疗产生了不利影响。它对心血管疾病诊断护理的影响尚未量化，心血管疾病仍然是全球死亡的主要原因。目标 该研究旨在评估 COVID-19 对全球心血管诊断程序量和安全实践的影响。方法 国际原子能机构开展了一项全球调查，评估因 COVID-19 导致的心血管手术量和安全实践的变化。从参与地点获得了 2020 年 3 月和 4 月的无创和有创心脏检测量，并与 2019 年 3 月的检测量进行了比较。确定了个人防护设备的可用性和与大流行相关的检测实践的变化。结果 调查由 108 个国家/地区 909 个进行心脏诊断程序的住院和门诊中心提交。从 2019 年 3 月到 2020 年 3 月，手术量减少了 42%，从 2019 年 3 月到 2020 年 4 月，手术量减少了 64%。经胸超声心动图减少了 59%，经食管超声心动图减少了 76%，压力测试减少了 78%，不同的压力模式有所不同。冠状动脉造影（侵入性或计算机断层扫描）减少 55%（每次手术 p < 0.001）。在多变量回归中，国内生产总值较低国家的中心的程序明显减少。位于低收入和中低收入国家的心脏手术次数会额外减少 22%，而且个人防护设备和远程医疗的可用性也会降低。结论 COVID-19 与全球心血管诊断检测的显着突然减少有关，特别是对世界经济困难地区的影响。有必要进一步研究心血管结局和与 COVID-19 相关的护理服务变化。