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

Dai K.Z. Bremner L. Cohen Y. Karthikeyan G. Pascual T.N.B. Lu B. Albadr A. Bom H.-S.H. Dautov T. Fatima S. Haidar M. Iguchi N. Kang F.Y.J. Khiewvan B. Nanayakkara D. Nguyen P.M.H. Patel C. Rozikhodjaeva G. Better N. Cerci R.J. Dorbala S. Shaw L.J. Villines T.C. Vitola J.V. Williams M.C. Choi A.D. Malkovskiy E. Randazzo M. Gianmarile F. Pynda Y. Dondi M. Paez D. Einstein A.J.
27 February 2025 BMJ Publishing Group

Open Heart
2025 #12 Issue 1

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.

COVID-19 , Echocardiography , Global Health

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New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, United States
Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
Childrens Hospital, New York, NY, United States
All India Institute of Medical Sciences, New Delhi, India
Philippine Nuclear Research Institute, Quezon City, Philippines
Fuwai Hospital, Beijing, China
Al-Amal National Hospital, Baghdad, Iraq
Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Hwasun-gun, South Korea
National Research Cardiac Surgery Center, Astana, Kazakhstan
Pakistan Atomic Energy Commission, Islamabad, Pakistan
American University of Beirut Medical Center, Beirut, Lebanon
Sakakibara Heart Institute, Fuchu, Japan
National Heart Centre, Singapore
Department of Radiology, Mahidol University, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
Nuclear Medicine Unit, University of Peradeniya, Faculty of Medicine, Peradeniya, Sri Lanka
Department of Nuclear Medicine, Cho Ray Hospital, Ho Chi Minh, Viet Nam
All India Institute of Medical Sciences, New Delhi, India
Central Clinical Hospital No. 1 of the Main Medical Directorate, The Republic of Uzbekistan Administration, Tashkent, Uzbekistan
Cabrini Health, Malvern, VIC, Australia
Research and Innovation, Quanta Diagnostico, Curitiba, Brazil
Harvard Medical School, Boston, MA, United States
Blavatnik Family Womens Health Research Institute, Mount Sinai Medical Center, New York, NY, United States
University of Virginia, Charlottesville, VA, United States
Quanta Diagnóstico por Imagem, Curitiba, Brazil
Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, United Kingdom
Department of Medicine, Division of Cardiology, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
Department of Medicine, Division of Cardiology, George Washington University School of Public Health and Health Services, Washington, DC, United States
Section of Cardiology, The University of Chicago Medical Center, Chicago, IL, United States
International Atomic Energy Agency, Vienna, Austria
Division of Human Health, Department of Nuclear Sciences and Applications, IAEA, Vienna, Austria
Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Department of Radiology, Columbia University, New York, NY, United States

New York-Presbyterian/Columbia University Irving Medical Center
Columbia University Vagelos College of Physicians and Surgeons
Seymour
Childrens Hospital
All India Institute of Medical Sciences
Philippine Nuclear Research Institute
Fuwai Hospital
Al-Amal National Hospital
Department of Nuclear Medicine
National Research Cardiac Surgery Center
Pakistan Atomic Energy Commission
American University of Beirut Medical Center
Sakakibara Heart Institute
National Heart Centre
Department of Radiology
Nuclear Medicine Unit
Department of Nuclear Medicine
All India Institute of Medical Sciences
Central Clinical Hospital No. 1 of the Main Medical Directorate
Cabrini Health
Research and Innovation
Harvard Medical School
Blavatnik Family Womens Health Research Institute
University of Virginia
Quanta Diagnóstico por Imagem
Centre for Cardiovascular Sciences
Department of Medicine
Department of Medicine
Section of Cardiology
International Atomic Energy Agency
Division of Human Health
Seymour

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