Association of COVID-19 public health measures with cardiac non-invasive testing utilisation in Ontario, Canada: a population-based, retrospective time series analysis

Background The COVID-19 pandemic disrupted healthcare delivery worldwide, beginning in early 2020. While cardiac non-invasive testing (NIT) plays a critical role in the evaluation and management of cardiovascular disease, the population-level association of pandemic-related public health measures on cardiac diagnostics remains unclear.

Objective To compare the rates and patterns of cardiac NIT before and after the implementation of the first and subsequent provincial COVID-19 lockdown measures. Design and setting A population-based and registry-based retrospective time series analysis conducted in Ontario, Canada, a single-payer healthcare system.

Participants All individuals receiving transthoracic echocardiography, stress echocardiography, nuclear imaging, cardiac CT or cardiac MRI between 17 March 2018 and 16 March 2022. Outcome measures Standardised weekly testing rates compared across pre-pandemic and pandemic intervals using ARIMA (autoregressive integrative moving average) modelling.