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The impact of COVID-19 on South African public-sector interventional radiology services - A single-centre study
Ursula Lesar1, Michelle Da Silva1, Richard Pitcher1
1Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Insights
The COVID-19 pandemic significantly reduced interventional radiology (IR) procedures in South Africa, particularly non-vascular ones. Vascular procedures showed a rebound effect post-lockdown, highlighting IR
Area of Science:
- Public Health
- Radiology
- Healthcare Management
Background:
- Limited understanding of COVID-19's impact on South African interventional radiology (IR) services.
- Need to assess the influence of the pandemic on IR procedures in a public sector tertiary hospital.
Purpose of the Study:
- To evaluate the effect of COVID-19 on interventional radiology (IR) procedures in South Africa.
- To analyze changes in vascular and non-vascular IR procedures during different lockdown phases.
Main Methods:
- Retrospective audit of IR procedures over three 9-week periods in 2020: pre-strict lockdown, strict lockdown, and post-strict lockdown.
- Data stratified by patient demographics, procedure type (vascular/non-vascular), time, and location.
- Comparison of incidence rates of procedures between the three periods.
Main Results:
- Overall IR procedures decreased by 24.3% during strict lockdown and 6.4% in the post-lockdown period compared to pre-lockdown.
- Non-vascular procedures saw significant declines of 29.8% (lockdown) and 17.6% (post-lockdown).
- Vascular procedures decreased by 9.1% during lockdown but increased by 17.1% post-lockdown, showing a rebound effect.
Conclusions:
- The COVID-19 pandemic significantly impacted both vascular and non-vascular IR procedures in South Africa.
- Variable effects observed between strict lockdown and post-lockdown periods, with a notable rebound in vascular procedures.
- Provides insights into the evolving role of IR within African healthcare systems during the pandemic.
Background:
Little is known about the impact of coronavirus disease 2019 (COVID-19) on South African interventional radiology (IR) services. This study aimed to assess the influence of COVID-19 on IR procedures at a tertiary-level public sector South African (SA) hospital.
Methods:
A retrospective audit of IR procedures over three 9-week periods in 2020: Period (1) pre-strict lockdown (23 January-25 March), period (2) strict lockdown (26 March-27 May) and period (3) post-strict lockdown (28 May-30 June). Data were captured and stratified by patient demographics, procedure indication, nature (vascular or non-vascular), time (normal or after-hours) and location (IR suite or ward). Calculated incidence rates of categories per period were performed and then compared between the three periods.
Results:
There were 288, 218 and 204 procedures performed in periods 1, 2 and 3, respectively, with no significant proportional variation in gender, age, after-hours or ward procedures across the periods. During period 2, the overall (n = 218, p = 0.002), non-vascular (n = 148, p = 0.001) and vascular procedures (n = 70, p = 0.999) decreased by 24.3%, 29.8% and 9.1%, respectively. During period 3, the overall (n = 204, p = 0.496) and non-vascular (n = 122, p = 0.590) procedures declined by a further 6.4% and 17.6%, respectively, while vascular procedures (n = 82, p = 0.410) increased by 17.1%. In period 3, the overall (n = 204, p = 0.001) and non-vascular procedures (n = 122, p ≤ 0.001) were 29.1% and 42.2% lower than period 1 levels, whereas vascular procedures (n = 82, p ≥ 0.999) demonstrated the so-called 'rebound phenomenon', exceeding period 1 by 6.5%.
Conclusion:
COVID-19 pandemic impacted non-vascular and vascular IR procedures with variable difference between periods of strict lockdown and post-strict lockown. This affords a perspective on the emerging role of IR in health systems across the African continent.
Contribution:
This study provides unique insights into the impact of COVID-19 on SA IR services.
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