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

## TL;DR

This study examines how the COVID-19 pandemic affected interventional radiology services in a South African hospital during and after lockdown periods.

## Contribution

The study provides unique insights into the impact of the pandemic on interventional radiology services in a South African public-sector hospital.

## Key findings

- Non-vascular procedures decreased significantly during strict lockdown and remained lower afterward.
- Vascular procedures showed a 'rebound phenomenon' post-lockdown, exceeding pre-pandemic levels.
- Overall procedure numbers dropped during lockdown but did not fully recover afterward.

## Abstract

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.

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.

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%.

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.

This study provides unique insights into the impact of COVID-19 on SA IR services.