Recovery of cardiovascular testing in Asia during the COVID-19 pandemic: findings from the INCAPS COVID 2 study

INCAPS COVID 2 Investigators Group, Kathy Z Dai, Luca Bremner, Yosef Cohen, Ganesan Karthikeyan, Thomas NB Pascual, Bin Lu, Amjed Albadr, Hee-Seung Henry Bom, Tairkhan Dautov, Shazia Fatima, Mohamad Haidar, Nobuo Iguchi, Felix YJ Kang, Benjapa Khiewvan, Damayanthi Nanayakkara, Phuoc Minh Hiep Nguyen, Chetan Patel, Gulnora Rozikhodjaeva, Nathan BetterRodrigo J Cerci, Sharmila Dorbala, Leslee J Shaw, Todd C Villines, João V Vitola, Michelle C Williams, Andrew D Choi, Eli Malkovskiy, Michael Randazzo, Francesco Gianmarile, Yaroslav Pynda, Maurizio Dondi, Diana Paez, Andrew J Einstein

Research output: Contribution to journalArticlepeer-review

Abstract

Background
Understanding pandemic-related reductions and subsequent recovery of cardiovascular testing in Asia is important for guiding regional public health efforts.
Objectives
This study sought to evaluate the recovery of cardiovascular testing in Asia 1 year into the COVID-19 pandemic.
Methods
In this subanalysis of a worldwide survey on the impact of COVID-19 on cardiovascular diagnostic care in April 2020 and April 2021, recovery of testing volume in Asia was compared among subregions, World Bank income groups and imaging modalities.
Results
Of 669 sites worldwide, 164 sites were in 33 Asian countries. Cardiovascular testing volumes in Asia decreased by 53% from March 2019 to April 2020, then recovered 96% of this decrease by April 2021, compared with 98% recovery in the rest of the world. Eastern Asia and Western and Central Asia reported recovery rates of 123% and 110%, compared with 50% and 80% recovery in Southern and South-eastern Asia. Testing volumes among high-income and upper-middle-income Asian countries recovered to 117% and 121% but remained depressed at 49% and 14% recovery in lower-middle and low-income countries, respectively. Stress ECG, stress echo and stress positron emission tomography studies experienced median reductions of 48%, 35% and 57% in testing volume between March 2019 and April 2021, while volumes of coronary artery calcium, coronary CT angiography and cardiac MR remained stable during this period.
Conclusions
The recovery of cardiovascular testing in Asia 1 year into the COVID-19 pandemic lagged in the Southern and South-eastern subregions, as well as in lower-income countries. Recovery favoured advanced cardiac imaging modalities over standard stress testing modalities.
Original languageEnglish
Article numbere002935
JournalOpen heart
Volume12
Issue number1
DOIs
Publication statusPublished - 27 Feb 2025

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