The impact of COVID-19 on South African public-sector interventional radiology services – A single-centre study

Abstract

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.