How the Workload and Outcome of Imaging Examinations Changed During the COVID-19 Pandemic Lockdown How the Workload and Outcome of Imaging Examinations Changed During the COVID-19 Pandemic Lockdown

Main Article Content

Vincenzo Vingiani
Andres F. Abadia
Alessandro Posa
Antonio Corvino
Luigi Pasqualetto
Alfonso Presidente
Matteo Losco
Hunter N Gray
U. Joseph Schoepf


COVID-19; Emergency Department; Findings; Lockdown; Pandemics; Workflow.


Background: On March 9th, 2020, the Italian government decided to go into lockdown due to the COVID-19 pandemic, which led to changes in the workflow of radiological examinations.

Aims: Aim of the study is to illustrate how the workload and outcome of radiological exams changed in a community hospital during the pandemic.

Methods and Material: The exams performed in the radiology department from March 9th to March 29th, 2020 were retrospectively reviewed and compared to the exams conducted during the same time-period in 2019. Only exams coming from the emergency department (ED) were included. Two radiologists defined the cases as positive or negative findings, based on independent blind readings of the imaging studies. Categorical measurements are presented as frequency and percentages, and p-values are calculated using the Chi-squared test.

Results and Conclusions: There was a significant reduction in the amount of exams performed in 2020: there were 143 (93|65% male, 60.7±21.5 years) patients who underwent radiological examinations from the ED vs. 485 (255|53% male, 51.2±24.8 years) in 2019. Furthermore, the total number of ED exams dropped from 699 (2019) to 215 (2020). However, the percentage of patients with a positive result was significantly higher in 2020 (69|48%) compared to 2019 (151|31%) (p<.001).

The reduction of emergency radiological examinations might be a result of the movement restrictions enforced during the lockdown, and possible fear of the hospital as a contagious place. This translated to a relative increase of positive cases as only patients with very serious conditions were accessing the ED.


Download data is not yet available.


Metrics Loading ...
Abstract 164 | PDF Downloads 30


1. Wang C, Horby PW, Hayden FG, et al. A novel coronavirus outbreak of global health concern. Lancet. 2020;395(10223):470-473. doi: 10.1016/S0140-6736(20)30185-9. PubMed PMID: 31986257; eng.
2. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-1242. doi: 10.1001/jama.2020.2648 %J JAMA.
3. Song F, Shi N, Shan F, et al. Emerging 2019 Novel Coronavirus (2019-nCoV) Pneumonia. 2020;295(1):210-217. doi: 10.1148/radiol.2020200274. PubMed PMID: 32027573.
4. Saglietto A, D'Ascenzo F, Zoccai GB, et al. COVID-19 in Europe: the Italian lesson. Lancet. 2020;395(10230):1110-1111. doi: 10.1016/S0140-6736(20)30690-5. PubMed PMID: 32220279; eng.
5. Remuzzi A, Remuzzi G. COVID-19 and Italy: what next? Lancet. 2020;395(10231):1225-1228. doi: 10.1016/S0140-6736(20)30627-9. PubMed PMID: 32178769; eng.
6. Government of Italy. Decree of the President of the Council of ministers March 9th 2020. Published March 9, 2020. Accessed May 1, 2020.
7. COVID-19 Task Force of the Department of Infectious Diseases and the IT Service Instituto Superiore di Sanità, March 30th 2020 Published March 30, 2020. Accessed May 1, 2020.
8. Cao Y, Li Q, Chen J, et al. Hospital Emergency Management Plan During the COVID-19 Epidemic. Acad Emerg Med. 2020;27(4):309-311. doi: 10.1111/acem.13951. PubMed PMID: 32124506; eng.
9. Trovato P SI, Rinaldo C, Grimaldi D, Verde F, Lomoro P, Codella U, De Rosa F, Corvino A, Giovine S. COVID-19 integrated imaging: our experience and literature review. Polish J Rad. 2020;Epub ahead of print.
10. Mossa-Basha M, Meltzer CC, Kim DC, et al. Radiology Department Preparedness for COVID-19: Radiology Scientific Expert Panel. Radiology. 2020 Mar 16;0(0):200988. doi: 10.1148/radiol.2020200988. PubMed PMID: 32175814.
11. Wan YL, Schoepf UJ, Wu CC, et al. Preparedness and Best Practice in Radiology Department for COVID-19 and Other Future Pandemics of Severe Acute Respiratory Infection. Journal of thoracic imaging. 2020 May 6;Publish Ahead of Print. doi: 10.1097/RTI.0000000000000529. PubMed PMID: 32384412.
12. Iezzi R, Valente I, Cina A, et al. Longitudinal study of interventional radiology activity in a large metropolitan Italian tertiary care hospital: how the COVID-19 pandemic emergency has changed our activity. 2020:1-10.
13. Albano D, Bruno A, Bruno F, et al. Impact of coronavirus disease 2019 (COVID-19) emergency on Italian radiologists: a national survey. 2020:1-10.
14. Christey G, Amey J, Campbell A, et al. Variation in volumes and characteristics of trauma patients admitted to a level one trauma centre during national level 4 lockdown for COVID-19 in New Zealand. N Z Med J. 2020 Apr 24;133(1513):81-88. PubMed PMID: 32325471.
15. Houshyar R, Tran-Harding K, Glavis-Bloom J, et al. Effect of shelter-in-place on emergency department radiology volumes during the COVID-19 pandemic. Emergency Radiology. 2020 2020/06/05. doi: 10.1007/s10140-020-01797-y.
16. Cavallo JJ, Forman HP. The Economic Impact of the COVID-19 Pandemic on Radiology Practices.0(0):201495. doi: 10.1148/radiol.2020201495. PubMed PMID: 32293225.
17. Stempniak M. Mednax sees ‘meaningful’ decline in radiology volume during pandemic, revises revenue forecasts. Radiology Business; Published Mar 25, 2020. Accessed May 8, 2020. Available from:;
18. Phillips CD, Shatzkes DR, Moonis G, et al. From the Eye of the Storm: Multi-Institutional Practical Perspectives on Neuroradiology from the COVID-19 Outbreak in New York City. 2020. doi: 10.3174/ajnr.A6565 %J American Journal of Neuroradiology.
19. Lazzerini M, Barbi E, Apicella A, et al. Delayed access or provision of care in Italy resulting from fear of COVID-19. Lancet Child Adolesc Health. 2020;4(5):e10-e11. doi: 10.1016/S2352-4642(20)30108-5. PubMed PMID: 32278365; eng.
20. Chang HJ, Huang N, Lee CH, et al. The impact of the SARS epidemic on the utilization of medical services: SARS and the fear of SARS. Am J Public Health. 2004 Apr;94(4):562-4. doi: 10.2105/ajph.94.4.562. PubMed PMID: 15054005; PubMed Central PMCID: PMCPMC1448298. eng.
21. Hanna TN, Kundu S, Singh K, et al. Emergency department imaging superusers. Emergency Radiology. 2019 2019/04/01;26(2):161-168. doi: 10.1007/s10140-018-1659-y.
22. Sena G, Gallelli G. An increased severity of peripheral arterial disease in the covid-19 era. J Vasc Surg. 2020. doi: 10.1016/j.jvs.2020.04.489. PubMed PMID: PMC7192106; eng.
23. Werner MT, Carey RM, Albergotti WG, et al. Impact of the COVID-19 Pandemic on the Management of Head and Neck Malignancies.0(0):0194599820921413. doi: 10.1177/0194599820921413. PubMed PMID: 32312163.
24. Angelini V VA, Belotti A, Castagnoli F, Frittoli B, Corvino A, Brunetti A, Grazioli L. . Incidental findings suggestive of COVID-19 in asymptomatic patient with Multiple Myeloma undergoing Whole-Body MRI in High prevalence region. Egyptian J Radiology and Nuclear Medicine 2020;Epub ahead of print.
25. Sverzellati N, Milanese G, Milone F, et al. Integrated Radiologic Algorithm for COVID-19 Pandemic. Journal of thoracic imaging. 2020 Apr 7;Publish Ahead of Print. doi: 10.1097/RTI.0000000000000516. PubMed PMID: 32271278.
26. Sabatino V SP, Muri M, Zangrandi I, Voltini G, Bosio G, Betti M, Baglivo F, Martinelli E, Pan A, Pierfranceschi GM, Corvino A, Romanini L. COVID-19: HRTC findings in 64 patients admitted to the Hospital of Cremona, an epicentre of the epidemic in Italy. Polish J Rad. 2020;Epub ahead of print.
27. Roda WC, Varughese MB, Han D, et al. Why is it difficult to accurately predict the COVID-19 epidemic? Infect Dis Model. 2020;5:271-281. doi: 10.1016/j.idm.2020.03.001. PubMed PMID: 32289100; eng.
28. Colbourn T. COVID-19: extending or relaxing distancing control measures. Lancet Public Health. 2020:S2468-2667(20)30072-4. doi: 10.1016/S2468-2667(20)30072-4. PubMed PMID: 32220654; eng.

Most read articles by the same author(s)