LAUSR

Objectives The COVID-19 pandemic has disrupted the delivery of preventative care and management of acute diseases. This study assesses the effect of the COVID-19 pandemic on coronary calcium score and coronary CT angiography imaging volume. Materials & Methods A single institution retrospective review of consecutive patients presenting for coronary calcium score or coronary CT angiography examinations between January 1, 2020 to January 4, 2022 was performed. The weekly number of calcium score and coronary CT angiogram exams were compared over four periods: a baseline pre-COVID-19 period (1/1/2020–3/10/2020); “COVID-19 peak” period (3/11/2020–5/2/2020); 2020 recovery period (5/3/2020-1/4/2021), and 2021 recovery period (1/5/21-1/4/2022). Results Overall, 1,817 coronary calcium score CT and 5,895 coronary CT angiogram examinations were performed. The average weekly volume of coronary CTA and coronary calcium score CT exams decreased by up to 83% and 100%, respectively, during the COVID-19 peak period compared to the pre-COVID-19 peak period (p<.0001 for both). The post-COVID recovery through 2020 saw weekly coronary CTA volumes rebound to 86% of baseline (49.7 vs. 57.6, p=.024), while coronary calcium score CT volumes remained muted at only a 53% recovery (14.9 vs. 28.2; p<.001). In 2021, coronary CTA imaging eclipsed pre-COVID rates (65.7 vs. 57.6; p=.012), however coronary calcium score CT volume only reached 67% of baseline (18.9 vs. 28.2; p<.001). Conclusions A significant decrease in both coronary CTA and coronary calcium score CT volume occurred during the peak-COVID-19 period. During subsequent recovery periods in 2020 and 2021, coronary CTA imaging eventually superseded baseline rates, while coronary calcium score CT volumes only reached two thirds of baseline. These findings highlight the importance of resumption of screening exams as the pandemic continues and should prompt clinicians to be aware of potential undertreatment of patients with coronary artery disease as pandemic restrictions are lifted.