Pulmonary embolism during the COVID‐19 pandemic: decline in diagnostic procedures and incidence at a University Hospital

Nopp, Stephan; Janata‐Schwatczek, Karin; Prosch, Helmut; Shulym, Ihor; Königsbrügge, Oliver; Pabinger, Ingrid; Ay, Cihan

BACKGROUND: The COVID‐19 pandemic has focused medical attention on treating affected patients and protecting others from infection. However, concerns have been raised regarding the pandemic´s impact and associated containment measures (e.g. curfew, lockdown) on non‐COVID‐19‐related acute medical diseases. OBJECTIVES: To investigate changes in the incidence of pulmonary embolism (PE) during the COVID‐19 pandemic compared to the period prior to the pandemic and reference periods in previous years. METHODS: In this single‐center study, we explored all diagnostic imaging tests performed for suspected PE between week 1‐17 of the years 2018, 2019, and 2020. Incidence of PE (i.e. primary outcome) was analyzed. Secondary outcomes included number of imaging tests for suspected PE. RESULTS: Compared to week 1‐11, 2020, an abrupt decline in PE diagnosis (mean weekly rate: 5.2 [95%CI: 3.8‐6.6] vs. 1.8 [0.0‐3.6]) and imaging tests (32.5 [27.5‐37.6] vs. 17.3 [11.6‐23.1]) was observed from week 12, with beginning of the containment measures and public lockdown in Austria. Compared to week 12‐17 of 2018 and 2019, PE incidence and imaging tests were similarly decreased from 5.3 [3.6‐7.1] to 1.8 [0.0‐3.6] and 31.5 [27.1‐35.9] to 17.3 [11.6‐23.1]), respectively. The median (IQR) sPESI score of PE patients during the pandemic was higher than in all other PE patients (3 [1‐3] vs. 1 [0‐2]; p=0.002). CONCLUSION: Our study demonstrates that the Covid‐19 pandemic has an impact on non‐COVID‐19‐related acute diseases as shown by the decline in incidence of PE and imaging procedures for diagnostic work‐up. Further studies from other hospitals are needed to confirm our findings.