Amir Reza Radmard
1 
, Ali Gholamrezanezhad
2, Seyed Ali Montazeri
3, Amir Kasaeian
4, Nemat Nematollahy
5, Roghieh Molaee Langrudi
6, Reza Javad Rashid
7, Alireza Dehghan
8, Ali Hekmatnia
9, Ali Shakourirad
10, Masoud Pezeshki Rad
11, Reza Nafisi Moghadam
12, Hashem Sharifian
13, Ahmad Enhesari
14, Marzieh Aalinezhad
9, Ghazaleh Jamalipour Soufi
9, Alireza Shakibafard
15, Maryam Mohammadzadeh
13, Reza Jalli
8, Mehrdad Bakhshayeshkaram
16, Taraneh Faghihi Langroudi
17, Masoomeh Raoufi
18, Alireza Abrishami
19, Pooneh Dehghan
20, Hooman Bahrami-Motlagh
21, Hassan Hashemi
22, Morteza Sanei Taheri
23* 1 Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
2 Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
3 Department of Radiology, Mayo Clinic, Florida, USA
4 Department of Biostatistics and Epidemiology, Hematology-Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
5 Department of Radiology, 5 Azar Hospital, Golestan University of Medical Sciences, Gorgan, Iran
6 Diagnostic Radiology Department, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
7 Department of Radiology, Imam Reza hospital, Tabriz University of Medical Sciences, Tabriz, Iran
8 Department of Radiology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
9 Radiology Department, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
10 Department of Radiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
11 Department of Radiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
12 Department of Radiology, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
13 Department of Radiology, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran
14 Clinical Research Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
15 TABA Medical Imaging Center, Shiraz, Iran
16 Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
17 Department of Radiology, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
18 Department of Radiology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
19 Department of Radiology, Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
20 Department of Radiology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
21 Department of Radiology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
22 Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
23 Department of Radiology, Shohada-E-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract
Background: Chest computed tomography (CT) scan has been used widely to diagnose COVID-19 in Iran.
Objectives: To trace the footsteps of COVID-19 in Iran by exploring the trend in using chest CT scans and its economic impact on radiology departments. Methods: In this cross-sectional study, the number of imaging examinations from 33 tertiary radiology departments in 9 large cities of Iran was collected from September 23, 2019 to March 20, 2020 (Months 1 to 6) and the corresponding months in 2018–2019.
Results: A 50.2% increase was noted in the chest CT scan utilization in 2019–2020 compared to 2018–2019. This increase was +15%, +15%, +27%, +2%, +1% in Months 1–5 of 2019–2020, respectively. In Month 6 of 2019–2020, a 251% increase in the acquisition of chest CT scans was observed compared to the Month 6 of 2018–2019. Following negative balance of revenue from Month 1 to 5 with respect to the inflation rate, the total income in Month 6 was further 1.5% less than the same Month in 2018–19.
Conclusion: The observed peak in chest CT utilization in Month 3 prior to the surge in Month 6 could be explained by the seasonal influenza. However, unawareness about an emerging viral disease, i.e. COVID-19, might have underutilized chest CT in Months 4 and 5 before the official announcement in Month 6. The unbalanced increase in the workload of radiology departments in the shortage of cardiothoracic radiologists with the simultaneous decrease in income initiated a vicious cycle that worsened the economic repercussions of the pandemic.