How did the COVID-۱۹ pandemic affect the referral patterns for SPECT myocardial perfusion? A single center experience

Objective(s): We evaluated the impact of the COVID-۱۹ pandemic on the number of referrals for SPECT myocardial perfusion imaging (SPECT-MPI) as well as changes in the clinical and imaging characteristics.Methods: We respectively reviewed ۱۰۴۲ SPECT-MPI cases performed in a ۴-month period during the COVID-۱۹ pandemic (PAN; n=۴۲۳) and compared their findings with those acquired in the same months before the pandemic (PRE; n=۶۱۹).Results: The number of stress SPECT-MPI studies performed during the PAN period significantly dropped compared to the number of studies carried out in the PRE period (p = ۰.۰۱۴). In the PRE period, the rates of patients presenting with non-anginal, atypical and typical chest pain were ۳۱%, ۲۵% and ۱۹%, respectively. The figures significantly changed in the PAN period to ۱۹%, ۴۲%, and ۱۱%, respectively (all p-values <۰.۰۰۱). Regarding the pretest probability of coronary artery disease (CAD), a significant decrease and increase were noticed in patients with high and intermediate pretest probability, respectively (PRE: ۱۸% and ۵۵%, PAN: ۶% and ۶۵%, p <۰.۰۰۱ and ۰.۰۰۸, respectively). Neither the rates of myocardial ischemia nor infarction differed significantly in the PRE vs. PAN study periods.Conclusion: The number of referrals dropped significantly in the PAN era. While the proportion of patients with intermediate risk for CAD being referred for SPECT-MPI increased, those with high pretest probability were less frequently referred. Image parameters were mostly comparable between the study groups in the PRE and PAN periods.

Keywords:

COVID-۱۹ , myocardial perfusion imaging , SPECT-MPI