COVID-19 vaccination coverage may be on the rise, but the pandemic has gone nowhere. But it’s not just the virus that lingers – many previously infected patients are still feeling the effects of the disease.
Diagnosing COVID-19 positive patients during the early stages of the pandemic put a heavy strain on radiology, and according to Lillian Chiu, MD, a radiologist at New York Medical College, as more patients become “ long haulers, ” patients who experience long-lasting symptoms, which can increase the pressure on radiologists and imaging services.
In a poster presented at the American Roentgen Ray Society (ARRS) 2021 Virtual Annual Meeting, a team led by Chiu explained how an ongoing pandemic could affect radiology and what departments and imaging clinics can do to prepare.
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The amount of knowledge around COVID-19 continues to grow, and the past year has already shown that radiology services are essential for good patient care, the team said.
“While we still know little about this disease and its short- and long-term effects, we expect more use will be made of radiological imaging studies to help define complications and the long-term consequences of COVID-19,” they said. .
That resurgence can occur in a variety of areas, including brain and heart imaging, as well as follow-up studies on complications from lung disease.
COVID-19 “long haulers” are largely outliers in patients who are recovering. Rather than overcoming the classic viral symptoms – cough, shortness of breath, and fatigue – within two to six weeks, these individuals have persistent or recurring symptoms for months. These problems can include those characteristic symptoms as well as chest and joint pain, arrhythmias, brain fog, headache, loss of taste or smell, and sore throat. Results from an Italian study, they said, revealed that 87.4 percent of patients reported at least one persistent symptom.
Most of these patients are over 50 and have additional co-morbidities, such as high blood pressure, obesity, chronic psychiatric conditions and immunosuppressive conditions, the team said. In many cases, they will require more and longer rehabilitation, with up to 50 percent requiring hospitalization. They also experience a decreased quality of life, accompanied by depression, anxiety and post-traumatic stress disorder, the team said.
And these issues don’t show any signs of slowing down.
“The effects we are seeing may be just the tip of the iceberg,” they said.
With persistent consequences for patients comes the possible persistent impact on radiology. From day one, radiology has played a critical role in diagnosing, managing, and monitoring COVID-19 patients, and the economic toll has been significant. Most imaging outpatient clinics saw their volumes drop by about 50 percent in March 2020, with mammography and elective services being the most drastically affected.
The pandemic also changed the way radiologists turn to working from home during the height of the outbreak. While this added safety, the team said, it also created distance between radiologists and imaging personnel.
While most healthcare facilities have pushed to provide as many services as possible in a pre-pandemic manner, the horizon is unclear. Therefore, radiology practices need to be prepared for potential increases in the number of caseloads and an increase in referrals’ requests, the team said.
“As the number of cases continues to increase across the country and the world, the number of long-haul vehicles may increase,” they said. “As the COVID-19 pandemic continues, radiology departments and leaders must adapt and prepare for the future. Organizations planning for adverse scenarios will find it easier to adapt and recover. “
Overall, Chiu’s team said those prep plans should consider personnel, equipment availability, and interdepartmental collaborations. They also need to evaluate their cybersecurity measures and plan to deal with a sudden influx of imaging volume.
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