Impact of the COVID-19 pandemic on corticosteroid injection services: A National Survey of Members of the British Society of Skeletal Radiologists (BSSR)

ObjectiveTo describe the restructuring of services by British radiologists in response to evolving national guidelines and highlight the impact of the COVID-19 pandemic on the treatment of musculoskeletal (MSK) conditions.MethodsAn online anonymised survey was distributed via the British Society of Skeletal Radiology (BSSR) members forum in November 2020. Responses were collated using a standardised Google form including 21 questions.Results135 members of the BSSR completed the survey. 85% of respondents stopped performing corticosteroid injections (CSI) during the initial lockdown of the pandemic. This was primarily influenced by national guidelines. The majority of respondents initially abstained from offered CSI procedures, then by November 2020, 69% of respondents were providing CSI for high and low risk patients, 23% were only providing CSI for low-risk patients with 8% still not performing any CSI. 40% of respondents reported routinely obtaining specific written consent regarding the risk of COVID-19. Approximately, 11,000 CSI were performed by respondents between March and November 2020 with no reported significant COVID-19-related complications. Over 80% of BSSR members reported that the number of CSI procedures that they performed dropped by more than 80% compared to usual. 73% of respondents reported an increased backlog of patients awaiting treatment. The average waiting time for routine outpatient CSI treatment was > 12 weeks in 53% of responses, compared to 34% the previous year.ConclusionThe COVID-19 pandemic has had a significant impact on the clinical practices of MSK radiologists in the UK. Our survey highlights the rapid response of BSSR members as national guidelines evolved. Currently, the majority of respondents are performing CSI for musculoskeletal conditions when clinically indicated, with enhanced consent. However, the pandemic has resulted in increased waiting times – delaying the treatment of patients who may be suffering with significant pain and disability. Further research is warranted to provide guidance around both service recovery and provision of CSI around COVID-19 vaccination schedules.Advances in knowledgeBSSR members responded rapidly to changing guidelines during the COVID-19 pandemic. The majority of respondents are currently performing CSI when clinically indicated. The pandemic has resulted in a significant increase in waiting times which will have a significant impact on UK musculoskeletal services.     

Radiology Imaging Volume Changes During Discrete COVID-19 Pandemic Waves: Implications for the Delta Variant of Coronavirus and Future Pandemics

PurposeThe aim of this study was to evaluate radiology imaging volumes at distinct time periods throughout the coronavirus disease 2019 (COVID-19) pandemic as a function of regional COVID-19 hospitalizations.MethodsRadiology imaging volumes and statewide COVID-19 hospitalizations were collected, and four 28-day time periods throughout the COVID-19 pandemic of 2020 were analyzed: pre–COVID-19 in January, the “first wave” of COVID-19 hospitalizations in April, the “recovery” time period in the summer of 2020 with a relative nadir of COVID-19 hospitalizations, and the “third wave” of COVID-19 hospitalizations in November. Imaging studies were categorized as inpatient, outpatient, or emergency department on the basis of patient location at the time of acquisition. A Mann-Whitney U test was performed to compare daily imaging volumes during each discrete 28-day time period.ResultsImaging volumes overall during the first wave of COVID-19 infections were 55% (11,098/20,011; P < .001) of pre–COVID-19 imaging volumes. Overall imaging volumes returned during the recovery time period to 99% (19,915/20,011; P = .725), and third-wave imaging volumes compared with the pre–COVID-19 period were significantly lower in the emergency department at 88.8% (7,951/8,955; P < .001), significantly higher for outpatients at 115.7% (8,818/7,621; P = .008), not significantly different for inpatients at 106% (3,650/3,435; P = .053), and overall unchanged when aggregated together at 102% (20,419/20,011; P = .629).ConclusionsMedical imaging rebounded after the first wave of COVID-19 hospitalizations, with relative stability of utilization over the ensuing phases of the pandemic. As widespread COVID-19 vaccination continues to occur, future surges in COVID-19 hospitalizations will likely have a negligible impact on imaging utilization.     

Quantitative assessment of lung involvement on chest CT at admission: Impact on hypoxia and outcome in COVID-19 patients

BackgroundThe aim of this study was to quantify COVID-19 pneumonia features using CT performed at time of admission to emergency department in order to predict patients' hypoxia during the hospitalization and outcome.MethodsConsecutive chest CT performed in the emergency department between March 1st and April 7th 2020 for COVID-19 pneumonia were analyzed. The three features of pneumonia (GGO, semi-consolidation and consolidation) and the percentage of well-aerated lung were quantified using a HU threshold based software. ROC curves identified the optimal cut-off values of CT parameters to predict hypoxia worsening and hospital discharge. Multiple Cox proportional hazards regression was used to analyze the capability of CT quantitative features, demographic and clinical variables to predict the time to hospital discharge.ResultsSeventy-seven patients (median age 56-years-old, 51 men) with COVID-19 pneumonia at CT were enrolled. The quantitative features of COVID-19 pneumonia were not associated to age, sex and time-from-symptoms onset, whereas higher number of comorbidities was correlated to lower well-aerated parenchyma ratio (rho = −0.234, p = 0.04) and increased semi-consolidation ratio (rho = −0.303, p = 0.008).Well-aerated lung (≤57%), semi-consolidation (≥17%) and consolidation (≥9%) predicted worst hypoxemia during hospitalization, with moderate areas under curves (AUC 0.76, 0.75, 0.77, respectively). Multiple Cox regression identified younger age (p < 0.01), female sex (p < 0.001), longer time-from-symptoms onset (p = 0.049), semi-consolidation ≤17% (p < 0.01) and consolidation ≤13% (p = 0.03) as independent predictors of shorter time to hospital discharge.ConclusionQuantification of pneumonia features on admitting chest CT predicted hypoxia worsening during hospitalization and time to hospital discharge in COVID-19 patients.     

The impact of COVID-19 quarantine efforts on emergency radiology and trauma cases

ObjectiveAmidst COVID-19 pandemic, many states have issued stay at home advisories and non-essential business closures to limit public exposure. During this “quarantine” period, it is important to understand the volume and types of emergency/trauma radiology cases to better prepare for the continuing and future pandemics. This study demonstrates new trends in pathologies and an overall increase in positive exams.MethodsA retrospective review of emergency department's imaging during the initial two weeks of this state's quarantine period, 3/23/2020–4/5/2020 was compared to similar dates of the previous year (“pre-quarantine” period), 3/25/2019–4/7/2019. One thousand emergency radiology and 991 trauma cases were evaluated. Of the emergency radiology cases 500 studies from each period were assessed, and from the trauma cases, 783 cases from pre-quarantine and 315 from the quarantine period were examined. Chi-square analysis was performed to assess for statistical significance.ResultsOverall there were 43.0% fewer emergency radiology studies performed during the quarantine period (n = 4530) compared to pre-quarantine period (n = 2585). Additionally, the number of positive cases was significantly higher (P = 0.0001) during the quarantine period (43.0%) compared to the pre-quarantine period (30.2%). Several trends in types of trauma were observed, including a significant increase in domestic violence during the quarantine period (P = 0.0081).DiscussionDifferent volumes and types of emergency/trauma imaging cases were observed during the recent quarantine period. Findings may assist emergency radiology departments to plan for future pandemics or COVID-19 resurgences by offering evidence of the types and volume of emergency radiology cases one might expect.     

Impact of the COVID-19 pandemic on clinical radiography practice in low resource settings: The Ghanaian radiographers’ perspective

IntroductionThe COVID-19 pandemic has altered the professional practice of all healthcare workers, including radiographers. In the pandemic, clinical practice of radiographers was centred mostly on chest imaging of COVID-19 patients and radiotherapy treatment care delivery to those with cancer. This study aimed to assess the radiographers’ perspective on the impact of the pandemic on their wellbeing and imaging service delivery in Ghana.MethodsA cross-sectional survey of practising radiographers in Ghana was conducted online from March 26th to May 6th, 2020. A previously validated questionnaire that sought information regarding demographics, general perspectives on personal and professional impact of the pandemic was used as the research instrument. Data obtained was analysed using Microsoft Excel® 2016.ResultsA response rate of 57.3% (134/234) was obtained. Of the respondents, 75.4% (n = 101) reported to have started experiencing high levels of workplace-related stress after the outbreak. Three-quarters (n = 98, 73.1%) of respondents reported limited access to any form of psychosocial support systems at work during the study period. Half (n = 67, 50%) of the respondents reported a decline in general workload during the study period while only a minority (n = 18, 13.4%) reported an increase in workload due to COVID-19 cases.ConclusionThis national survey indicated that majority of the workforce started experiencing coronavirus-specific workplace-related stress after the outbreak. Albeit speculative, low patient confidence and fear of contracting the COVID-19 infection on hospital attendance contributed to the decline in general workload during the study period.Implications for practiceIn order to mitigate the burden of workplace-related stress on frontline workers, including radiographers, and in keeping to standard practices for staff mental wellbeing and patient safety, institutional support structures are necessary in similar future pandemics.     

Spanish radiographers’ concerns about the COVID-19 pandemic

IntroductionThe current outbreak of COVID-19 has caused worldwide healthcare and social emergency in which healthcare professionals were under extreme work conditions while being fearful of becoming infected or spreading the disease to their relatives. The perceived threat of COVID-19 has the potential to cause severe psychological maladjustment. The aim of the study is to explore Spanish radiographers’ concerns about the COVID-19 pandemic.MethodsThis study was quantitative, observational and cross-sectional. The sample was made up of 546 radiographers working in Spain during the outbreak. The instrument used for analysis was an ad hoc questionnaire with socio-demographic questions and the questionnaire on perception of threat from COVID-19 validate to spanish healthcare professionals.ResultsThe sample consisted of 70.1% of female, 29.7% of male and 0.2% undeclare sex participants. The results showed a high level of a perceived threat from COVID-19 (7.57 ± 0.088), furthermore we observed a high level of threat about the possibility of infecting family members (8.49 ± 0.25), patients (8.33 ± 0.086), and coworkers (8.35 ± 0.084). Furthermore, females have a higher level of a perception of threat to spread infection between patients (r = ?0.136; p = 0.001) and coworkers (r = ?0.118; p = 0.006), than males.ConclusionCOVID-19 pandemic is perceived as a serious threat, being especially concerned about the threat of spreading the infection to family, coworkers, and patients. The perception of risk depends partly on professionals’ gender and family responsibilities.Implications for practiceOur findings suggest that it is recommended that healthcare professionals receive formation to reinforce and improve their emotional competencies for coping successfully with potentially stressful situations like COVI19 pandemic.     

Addressing ethnic disparities in imaging utilization and clinical outcomes for COVID-19

PurposeRacial and ethnic disparities have exacerbated during the COVID-19 pandemic as the healthcare system is overwhelmed. While Hispanics are disproportionately affected by COVID-19, little is known about ethnic disparities in the hospital settings. This study investigates imaging utilization and clinical outcomes between Hispanic and non-Hispanic COVID-19 patients in the Emergency Department (ED) and during hospitalization.MethodsThrough retrospective chart review, we included 331 symptomatic COVID-19 patients (mean age 53.2 years) at a metropolitan healthcare system from March to June 2020. Poisson regression was used to compare diagnostic imaging utilization and clinical outcomes between Hispanic and non-Hispanic patients.ResultsAfter adjusting for confounders, no statistically significant difference was found between Hispanic and non-Hispanic patients for the number of weekly chest X-rays. Results were categorized into four clinical outcomes: ED management (0.16 ± 0.05 vs. 0.14 ± 0.8, p:0.79); requiring inpatient management (1.31 ± 0.11 vs. 1.46 ± 0.16, p:0.43); ICU admission without invasive ventilation (1.4 ± 0.17 vs. 1.35 ± 0.26, p:0.86); and ICU admission and ventilator support (3.29 ± 0.22 vs. 3.59 ± 0.37, p:0.38). There were no statistically significant relative differences in adjusted prevalence rate between ethnic groups for all clinical outcomes (p > 0.05). There was a statistically significant longer adjusted length of stay (days) in non-Hispanics for two subcohorts: inpatient management (8.16 ± 0.31 vs. 9.72 ± 0.5, p < 0.01) and ICU admission without invasive ventilation (10.39 ± 0.57 vs. 13.45 ± 1.13, p < 0.01).ConclusionsFor Hispanic and non-Hispanic COVID-19 patients in the ED or hospitalized, there were no statistically significant differences in imaging utilization and clinical outcomes.     

Increased per-patient imaging utilization in an emergency department setting during COVID-19

IntroductionCOVID-19 has resulted in decreases in absolute imaging volumes, however imaging utilization on a per-patient basis has not been reported. Here we compare per-patient imaging utilization, characterized by imaging studies and work relative value units (wRVUs), in an emergency department (ED) during a COVID-19 surge to the same period in 2019.MethodsThis retrospective study included patients presenting to the ED from April 1–May 1, 2020 and 2019. Patients were stratified into three primary subgroups: all patients (n = 9580, n = 5686), patients presenting with respiratory complaints (n = 1373, n = 2193), and patients presenting without respiratory complaints (n = 8207, n = 3493). The primary outcome was imaging studies/patient and wRVU/patient. Secondary analysis was by disposition and COVID status. Comparisons were via the Wilcoxon rank-sum or Chi-squared tests.ResultsThe total patients, imaging exams, and wRVUs during the 2020 and 2019 periods were 5686 and 9580 (−41%), 6624 and 8765 (−24%), and 4988 and 7818 (−36%), respectively, and the percentage patients receiving any imaging was 67% and 51%, respectively (p < .0001). In 2020 there was a 170% relative increase in patients presenting with respiratory complaints. In 2020, patients without respiratory complaints generated 24% more wRVU/patient (p < .0001) and 33% more studies/patient (p < .0001), highlighted by 38% more CTs/patient.ConclusionWe report increased per-patient imaging utilization in an emergency department during COVID-19, particularly in patients without respiratory complaints.     

Mediastinal lymphadenopathy may predict 30-day mortality in patients with COVID-19

PurposeThere is scarce data on the impact of the presence of mediastinal lymphadenopathy on the prognosis of coronavirus-disease 2019 (COVID-19). We aimed to investigate whether its presence is associated with increased risk for 30-day mortality in a large group of patients with COVID-19.MethodIn this retrospective cross-sectional study, 650 adult laboratory-confirmed hospitalized COVID-19 patients were included. Patients with comorbidities that may cause enlarged mediastinal lymphadenopathy were excluded. Demographics, clinical characteristics, vital and laboratory findings, and outcome were obtained from electronic medical records. Computed tomography scans were evaluated by two blinded radiologists. Univariate and multivariate logistic regression analyses were performed to determine independent predictive factors of 30-day mortality.ResultsPatients with enlarged mediastinal lymphadenopathy (n = 60, 9.2%) were older and more likely to have at least one comorbidity than patients without enlarged mediastinal lymphadenopathy (p = 0.03, p = 0.003). There were more deaths in patients with enlarged mediastinal lymphadenopathy than in those without (11/60 vs 45/590, p = 0.01). Older age (OR:3.74, 95% CI: 2.06–6.79; p < 0.001), presence of consolidation pattern (OR:1.93, 95% CI: 1.09–3.40; p = 0.02) and enlarged mediastinal lymphadenopathy (OR:2.38, 95% CI:1.13–4.98; p = 0.02) were independently associated with 30-day mortality.ConclusionIn this large group of hospitalized patients with COVID-19, we found that in addition to older age and consolidation pattern on CT scan, enlarged mediastinal lymphadenopathy were independently associated with increased mortality. Mediastinal evaluation should be performed in all patients with COVID-19.     

Correlation of chest radiography findings with the severity and progression of COVID-19 pneumonia

PurposeAim is to assess the temporal changes and prognostic value of chest radiograph (CXR) in COVID-19 patients.Material and methodsWe performed a retrospective study of confirmed COVID-19 patients presented to the emergency between March 07–17, 2020. Clinical & radiological findings were reviewed. Clinical outcomes were classified into critical & non-critical based on severity. Two independent radiologists graded frontal view CXRs into COVID-19 pneumonia category 1 (CoV-P1) with <4 zones and CoV-P2 with ≥4 zones involvement. Interobserver agreement of CoV-P category for the CXR preceding the clinical outcome was assessed using Kendall's τ coefficient. Association between CXR findings and clinical deterioration was calculated along with temporal changes of CXR findings with disease progression.ResultsSixty-two patients were evaluated for clinical features. 56 of these (total: 325 CXRs) were evaluated for radiological findings. Common patterns were progression from lower to upper zones, peripheral to diffuse involvement, & from ground glass opacities to consolidation. Consolidations starting peripherally were noted in 76%, 93% and 48% with critical outcomes, respectively. The interobserver agreement of the CoV-P category of CXRs in the critical and non-critical outcome groups were good and excellent, respectively (τ coefficient = 0.6 & 1.0). Significant association was observed between CoV-P2 and clinical deterioration into a critical status (χ2 = 27.7, p = 0.0001) with high sensitivity (95%) and specificity (71%) within a median interval time of 2 days (range: 0–4 days).ConclusionInvolvement of predominantly 4 or more zones on frontal chest radiograph can be used as predictive prognostic indicator of poorer outcome in COVID-19 patients.     

Running behavior and symptoms of respiratory tract infection during the COVID-19 pandemic: A large prospective Dutch cohort study

ObjectivesTo explore changes in running behavior due to the Coronavirus Disease 2019 (COVID-19) pandemic, assess presence of symptoms suggestive for COVID-19 and identify whether there is an association between running behavior and COVID-19.DesignProspective cohort study.MethodsFor this study we used a cohort of runners participating in an ongoing randomized controlled trial on running injury prevention among recreational runners. At baseline, demographic and training variables were collected. Seven weeks after starting the lockdown, information on running behavior (interval training, training with partner and physical distancing during training) and running habits (training frequency, duration, distance and speed) were obtained. Furthermore, healthcare utilization and symptoms suggestive for COVID-19 were assessed. To determine the association between running and symptoms suggestive for COVID-19, univariate and multivariate logistic regression analyses were performed.ResultsOf the 2586 included participants, 2427 (93.9%) participants continued running during lockdown with no significant changes in mean weekly training variables. A total of 253 participants (9.8%) experienced symptoms suggestive for COVID-19 and 10 participants tested positive for COVID-19. Two participants were admitted to hospital due to COVID-19 with both one day of admission. Running behavior and running habits were not associated with the onset of symptoms suggestive for COVID-19.ConclusionsThe large majority of runners in the Netherlands did not change their running habits during lockdown. No association between running behavior or running habits and onset of symptoms suggestive for COVID-19 was identified. This implicates that running outdoor during lockdown does not negatively affect health of runners.     

Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients

BackgroundCoronavirus disease 2019 (COVID-19) has spread worldwide determining dramatic impacts on healthcare systems. Early identification of high-risk parameters is required in order to provide the best therapeutic approach. Coronary, thoracic aorta and aortic valve calcium can be measured from a non-gated chest computer tomography (CT) and are validated predictors of cardiovascular events and all-cause mortality. However, their prognostic role in acute systemic inflammatory diseases, such as COVID-19, has not been investigated.ObjectivesThe aim was to evaluate the association of coronary artery calcium and total thoracic calcium on in-hospital mortality in COVID-19 patients.Methods1093 consecutive patients from 16 Italian hospitals with a positive swab for COVID-19 and an admission chest CT for pneumonia severity assessment were included. At CT, coronary, aortic valve and thoracic aorta calcium were qualitatively and quantitatively evaluated separately and combined together (total thoracic calcium) by a central Core-lab blinded to patients’ outcomes.ResultsNon-survivors compared to survivors had higher coronary artery [Agatston (467.76 ​± ​570.92 vs 206.80 ​± ​424.13 ​mm², p ​< ​0.001); Volume (487.79 ​± ​565.34 vs 207.77 ​± ​406.81, p ​< ​0.001)], aortic valve [Volume (322.45 ​± ​390.90 vs 98.27 ​± ​250.74 mm², p ​< ​0.001; Agatston 337.38 ​± ​414.97 vs 111.70 ​± ​282.15, p ​< ​0.001)] and thoracic aorta [Volume (3786.71 ​± ​4225.57 vs 1487.63 ​± ​2973.19 mm², p ​< ​0.001); Agatston (4688.82 ​± ​5363.72 vs 1834.90 ​± ​3761.25, p ​< ​0.001)] calcium values. Coronary artery calcium (HR 1.308; 95% CI, 1.046–1.637, p ​= ​0.019) and total thoracic calcium (HR 1.975; 95% CI, 1.200–3.251, p ​= ​0.007) resulted to be independent predictors of in-hospital mortality.ConclusionCoronary, aortic valve and thoracic aortic calcium assessment on admission non-gated CT permits to stratify the COVID-19 patients in-hospital mortality risk.     

Trends in Academic Productivity Among Radiologists During the COVID-19 Pandemic

PurposeThere is a scarcity of literature examining changes in radiologist research productivity during the COVID-19 pandemic. The current study aimed to investigate changes in academic productivity as measured by publication volume before and during the COVID-19 pandemic.MethodsThis single-center, retrospective cohort study included the publication data of 216 researchers consisting of associate professors, assistant professors, and professors of radiology. Wilcoxon’s signed-rank test was used to identify changes in publication volume between the 1-year-long defined prepandemic period (publications between May 1, 2019, and April 30, 2020) and COVID-19 pandemic period (May 1, 2020, to April 30, 2021).ResultsThere was a significantly increased mean annual volume of publications in the pandemic period (5.98, SD = 7.28) compared with the prepandemic period (4.98, SD = 5.53) (z = ?2.819, P = .005). Subset analysis demonstrated a similar (17.4%) increase in publication volume for male researchers when comparing the mean annual prepandemic publications (5.10, SD = 5.79) compared with the pandemic period (5.99, SD = 7.60) (z = ?2.369, P = .018). No statistically significant changes were found in similar analyses with the female subset.DiscussionSignificant increases in radiologist publication volume were found during the COVID-19 pandemic compared with the year before. Changes may reflect an overall increase in academic productivity in response to clinical and imaging volume ramp down.     

COVID-19 and Breast Radiologist Wellness: Impact of Gender,Financial Loss,and Childcare Need

PurposeThe purpose of this study was to evaluate the emotional and financial impact of coronavirus disease 2019 (COVID-19) on breast radiologists to understand potential consequences on physician wellness and gender disparities in radiology.MethodsA 41-question survey was distributed from June to September 2020 to members of the Society of Breast Imaging and the National Consortium of Breast Centers. Psychological distress and financial loss scores were calculated on the basis of survey responses and compared across gender and age subgroups. A multivariate logistic model was used to identify factors associated with psychological distress scores.ResultsA total of 628 surveys were completed (18% response rate); the mean respondent age was 52 ± 10 years, and 79% were women. Anxiety was reported by 68% of respondents, followed by sadness (41%), sleep problems (36%), anger (25%), and depression (23%). A higher psychological distress score correlated with female gender (odds ratio [OR], 1.9; P = .001), younger age (OR, 0.8 per SD; P = .005), and a higher financial loss score (OR, 1.4; P < .0001). Participants whose practices had not initiated wellness efforts specific to COVID-19 (54%) had higher psychological distress scores (OR, 1.4; P = .03). Of those with children at home, 38% reported increased childcare needs, higher in women than men (40% versus 29%, P < .001). Thirty-seven percent reported that childcare needs had adversely affected their jobs, which correlated with higher psychological distress scores (OR, 2.2-3.3; P < .05).ConclusionsPsychological distress was highest among younger and female respondents and those with greater pandemic-specific childcare needs and financial loss. Practice-initiated COVID-19-specific wellness efforts were associated with decreased psychological distress. Policies are needed to mitigate pandemic-specific burnout and worsening gender disparities.     

A County-Level Analysis of the US Radiologist Workforce: Physician Supply and Subspecialty Characteristics

PurposeTo explore associations between county-level measures of radiologist supply and subspecialization and county structural and health-related characteristics.MethodsMedicare Physician and Other Supplier Public Use Files were used to subspecialty characterize 32,844 radiologists participating in Medicare between 2012 and 2014. Measures of radiologist supply and subspecialization were computed for 3,143 US counties. Additional county characteristics were identified using the 2014 County Health Rankings database. Mann-Whitney tests and Spearman correlations were performed.ResultsCounties with at least one (versus no) Medicare-participating radiologist had significantly (P < .001) larger populations (197,050 ± 457,056 versus 20,253 ± 23,689), lower rural percentages (39.5% ± 26.5% versus 74.6% ± 25.6%), higher household incomes ($47,608 ± $12,493 versus $42,510 ± $9,893), higher mammography screening rates (62.4% ± 7.0% versus 56.6% ± 15.3%), and lower premature deaths (7,581 ± 2,085 versus 7,784 ± 3,409 years of life lost). Counties’ radiologists per 100,000 population and percent of subspecialized radiologists showed moderate positive correlations with counties’ population (r = +0.505-+0.599) and moderate negative correlations with counties’ rural percentage (r = −0.434 to −0.523). Radiologist supply and degree of subspecialization both showed concurrent positive or negative weak associations with counties’ percent age 65+ (r = −0.256 to −0.271), percent Hispanic (r = +0.209-+0.234), and income (r = +0.230-+0.316). Radiologists per 100,000 population showed weak positive correlation with mammography screening (r = +0.214); percent of radiologists subspecialized showed weak negative correlation with premature death (r = −0.226).ConclusionGeographic disparities in radiologist supply at the community level are compounded by superimposed variation in the degree of subspecialization of those radiologists. The potential impact of such access disparities on county-level health warrants further investigation.     

Prevalencia y factores de desgaste profesional en radiólogos durante la pandemia COVID-19

BackgroundThe coronavirus 2019 (COVID-19) epidemic spread throughout the world from the beginning of 2020, increasing healthcare professionals’ workloads and levels of physical and emotional stress.AimsTo determine the prevalence of burnout syndrome in Spanish radiologists during the COVID-19 pandemic and the factors associated with the development of this syndrome, and to compare these findings with those obtained before the pandemic.MethodsThis observation study took place between April 2020 and August 2020 (during the pandemic) through an online survey. A total of 150 responses were obtained. Demographic and work-related information was compiled. Burnout syndrome was measured with the Maslach Burnout Inventory Human Services Survey (MBI-HSS). The prevalence and characteristics of burnout syndrome obtained in this survey were compared with those of the same survey done in 2019. We performed a statistical analysis to identify possible risk factors and protective factors associated with this syndrome and to determine the homogeneity of the two samples.ResultsThe prevalence of burnout syndrome increased during the COVID-19 pandemic (49.3% vs. 33.6%, p = 0.002). No risk factors or protective factors that were valid both before and after the pandemic were identified. No correlations were identified between sociodemographic or work-related characteristics and burnout syndrome.ConclusionThis study demonstrates that burnout syndrome increased significantly in radiologists during the COVID-19 pandemic, affecting nearly half of all those who responded to the survey. These results underline the need to assess support for professional wellbeing of radiologists in Spain. No correlations were identified between burnout and gender, age, number of calls, years in the job, annual income, teaching, marital status, number of children, or type of contract.