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Radiology Imaging Volume Changes During Discrete COVID-19 Pandemic Waves: Implications for the Delta Variant of Coronavirus and Future Pandemics

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ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacr.2021.09.045

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COVID-19 pandemic; medical imaging utilization; emergency department imaging; chest imaging; DVT ultrasound

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The study evaluated radiology imaging volumes during different time periods of the COVID-19 pandemic in relation to regional hospitalizations. Results showed fluctuations in imaging volumes, with a rebound after the first wave of COVID-19 hospitalizations and relative stability in subsequent phases. The findings suggest that as COVID-19 vaccination continues, future surges in hospitalizations are unlikely to significantly impact imaging utilization.
Purpose: The aim of this study was to evaluate radiology imaging volumes at distinct time periods throughout the coronavirus disease 2019 (COVID-19) pandemic as a function of regional COVID-19 hospitalizations. Methods: Radiology imaging volumes and statewide COVID-19 hospitalizations were collected, and four 28-day time periods throughout the COVID-19 pandemic of 2020 were analyzed: pre-COVID-19 in January, the first wave of COVID-19 hospitalizations in April, the ''recovery'' time period in the summer of 2020 with a relative nadir of COVID-19 hospitalizations, and the ''third wave'' of COVID-19 hospitalizations in November. Imaging studies were categorized as inpatient, outpatient, or emergency department on the basis of patient location at the time of acquisition. A Mann-Whitney U test was performed to compare daily imaging volumes during each discrete 28-day time period. Results: Imaging volumes overall during the first wave of COVID-19 infections were 55% (11,098/20,011; P < .001) of pre-COVID-19 imaging volumes. Overall imaging volumes returned during the recovery time period to 99% (19,915/20,011; P = .725), and third-wave imaging volumes compared with the pre-COVID-19 period were significantly lower in the emergency department at 88.8% (7,951/8,955; P < .001), significantly higher for outpatients at 115.7% (8,818/7,621; P = .008), not significantly different for inpatients at 106% (3,650/3,435; P = .053), and overall unchanged when aggregated together at 102% (20,419/20,011; P = .629). Conclusions: Medical imaging rebounded after the first wave of COVID-19 hospitalizations, with relative stability of utilization over the ensuing phases of the pandemic. As widespread COVID-19 vaccination continues to occur, future surges in COVID-19 hospitalizations will likely have a negligible impact on imaging utilization.

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