Evaluación de medidas de ahorro energético y su contribución a la sostenibilidad energética y ambiental

The world population has doubled in the last 60 years and is expected to grow to 9700 million people in 2050 and to 11,200 million by the end of the 21st century, which will have a strong impact on population structure, size, and distribution that will have profound consequences for environmental sustainability. This significant increase in population has resulted in global energy consumption increasing by more than 90% in the last decade and, consequently, CO2 emissions. These emissions contribute to the increase in the greenhouse effect caused by global warming. The alarming thing is that this has been caused by human activities and it is predicted that, if the current emissions trajectory continues, the Earth could exceed the limit of 2 °C of global warming, the limit established by the Paris Agreement to avoid dangerous warming that generates irreversible damage. The last five years have been the hottest since registration, with 2016 being the warmest, and successively 2015, 2017, 2018 and 2014. But global warming not only results in higher temperatures or adverse weather conditions, but the effects go even further, causing an increase in sea level, a change in ecosystems with the consequent disappearance of some species, the spread of diseases or an increase in the price of some foodstuffs, among others. These devastating effects that we are currently suffering and that are a consequence of the current development model, based on a continuous growth in energy consumption, should activate us to seek energy efficient solutions from an environmental point of view, as this model cannot be maintained indefinitely. It is indisputable that social, economic and technological changes and adaptations are required to preserve our well-being and the well-being of future generations. To this end, international agreements and policies have been implemented, such as the Paris Agreement on Climate Change in 2015, in which all the signatory countries committed themselves to participating in global reductions in greenhouse gases, Directive 2009/28/EC on the promotion of the use of energy from renewable sources or Directive 2012/27/EU on energy efficiency within the European Union, with the main objective of increasing energy efficiency. As the building sector is Europe's largest consumer of energy, almost all governments have opted for measures to promote renewable energy, energy efficiency strategies and climate change strategies. In this area, the European Union takes into account energy efficiency certificates, to classify the building according to its carbon emissions and energy consumption; and the 2020 objective, which requires by the end of next year a 20% saving in primary energy compared to 2005; a 20% reduction in greenhouse gas emissions compared to 1990 and an increase in renewable energies of at least a 20% by 2020. At the same time, Directive 2010/31/EU on the energy performance of buildings stipulates that all new buildings should be categorised as nZEB by the end of 2020 and, in the case of public buildings, this deadline is shortened to the end of 2018. Given the social concern to improve energy efficiency in buildings, considered as one of the basic pillars of the main national and international strategies to reduce greenhouse gas emissions, the scientific community has delved into this area by contributing an extensive production. Chapter II provides a bibliographical review of research on energy efficiency and sustainability during the period 1976-2016, in which some of the key aspects of publications are studied, such as the type of document that predominates, the language used, the area of knowledge in which it has been most published, the main journals, key words or authors. After having carried out in-depth research on sustainability and energy efficiency, Chapter III analyses the viability of replacing the existing gas boiler in a university building in the south of Spain with the introduction of a biomass boiler system. In environmental terms, biomass has a clear advantage over fossil fuels, since, although it produces atmospheric emissions when burned like any other fuel, these emissions are considered carbon neutral. This is due to the fact that the carbon dioxide emitted during combustion is compensated with that absorbed by the plant during its growth, thus not altering the balance of the concentration of carbon in the atmosphere. On the other hand, the properties associated with the date bone are analysed to evaluate its suitability as a new biofuel, obtaining that this waste product has a high calorific value that gives it optimum properties as a source of thermal energy comparable to other biofuels currently marketed. In addition, it would reduce about 95 tons of CO2 that are emitted by the natural gas boiler and would obtain an economic savings of more than 66%. Chapter IV studies the important contribution made by different international institutions in the field of energy saving. Energy saving and energy efficiency are terms related to a reduction in consumption, but there is nevertheless an important difference. While energy saving leads to a change in consumption habits, such as turning off lights when leaving a room, energy efficiency is the fact of minimising the amount of energy needed to satisfy demand without affecting its quality, for example, replacing existing light bulbs with others that consume less energy. It does not imply, therefore, changes in consumption habits, the behavior of the user, in this case, remains the same, but consumes less energy because the energy consumption to carry out the same service is lower. Obviously, in order to reduce energy consumption as much as possible, it would be necessary to combine energy saving and efficiency measures. In this chapter a bibliometric analysis of all the scientific production indexed in Scopus is carried out. World scientific production is analysed in the following areas: Firstly, the trend in time, types of publications and countries, secondly, the main themes and keywords, thirdly, the main institutions and their main themes, and fourthly, the main journals and proceedings they publish on this subject. These data are then presented using community detection algorithms and graphics visualization software. With these techniques it is possible to determine the main areas of research activity, as well as to identify the structures of the collaborative network in the field of renewable energies. The results of the work show that the literature in this field has increased substantially over the last 10 years. Finally, Chapter V carries out an energy review of the Reina Sofia University Hospital in Cordoba, analyzing data from the last 3 years. On the basis of these data, the current energy sources and areas of significant use of energy and equipment with the highest consumption, susceptible to energy improvements, are identified, and the first lines of improvement are proposed, which will materialise over time. A first energy baseline is also established for this period, which may be taken as a reference for calculating energy savings before and after implementing actions to improve energy performance. In conclusion, this Thesis proposes a reflection on energy efficiency and energy saving in public buildings, as well as the sustainability of the measures from an environmental and economic point of view, deepening the scientific production referred to these lines of research. At the same time, it tries to provide useful information on energy consumption in public buildings and propose possible energy-efficient actions in order to evolve towards a new more sustainable energy model, without diminishing the quality of life.La población mundial se ha duplicado en los últimos 60 años y se prevee que crezca hasta alcanzar los 9700 millones de personas en 2050 y hasta los 11.200 para el final del siglo XXI, lo que causará un fuerte impacto en la estructura, el tamaño, y la distribución poblacionales que tendrá profundas consecuencias para la sostenibilidad medioambiental. Este significativo aumento de la población ha tenido como consecuencia que el consumo global de la energía se haya incrementado más de un 90% en el último decalustro, y, consiguientemente, el aumento de las emisiones de CO2. Estas emisiones contribuyen al aumento del efecto invernadero que provoca el calentamiento global del planeta. Lo alarmante es que este ha sido causado por actividades humanas y se prevee que, de seguir con la actual trayectoria de emisiones, la Tierra podría superar el límite de 2 °C de calentamiento global, límite establecido por el Acuerdo de Paris para evitar un calentamiento peligroso que genere daños y perjuicios irreversibles. Los últimos cinco años han sido los más calientes desde que se tiene registro, siendo el 2016 el más cálido, y sucesivamente los años 2015, 2017, 2018 y 2014. Pero el calentamiento global no sólo tiene como consecuencia el aumento de las temperaturas o unas condiciones meteorológicas adversas, sino que los efectos van más allá provocando el aumento del nivel de mar, el cambio en los ecosistemas con la consiguiente desaparición de algunas especies, la propagación de enfermedades o el incremento en el precio de algunos alimentos entre otros. Estos efectos tan devastadores que actualmente estamos sufriendo y que son consecuencia del modelo de desarrollo actual, basado en un crecimiento continuo del consumo de energía, deberían activarnos a buscar soluciones eficientes energéticamente eficientes desde un punto de vista medioambiental, pues este modelo no se puede mantener indefinidamente. Es indiscutible que se requieren cambios y adaptaciones a nivel social, económico y tecnológico para preservar nuestro bienestar y el bienestar de las generaciones futuras. Para este fin se han implementado acuerdos y políticas internacionales como han sido el acuerdo de Paris sobre el cambio climático en 2015, donde todos los países firmantes se comprometían a participar en las reducciones globales de gases de efecto invernadero, la Directiva 2009/28/CE relativa al fomento del uso de energía procedente de fuentes renovables o la Directiva 2012/27/UE relativa a la eficiencia energética dentro de la Unión Europea con el objetivo principal de aumentar la eficiencia energética. Por ser el sector de la edificación el mayor consumidor de energía en Europa, casi todos los gobiernos han optado por la adopción de medidas destinadas a impulsar las energías renovables, las estrategias de eficiencia energética y las estrategias de lucha contra el cambio climático. La legislación en Europa en esta materia contempla, por un lado, la creación de certificados de eficiencia energética, desarrollados a principios de los años noventa como estrategia primaria para reducir el consumo de energía y las emisiones de carbono. Por otro lado, de la política energética adoptada en 2007, denominada Horizonte 20-20-20, en la que la UE exige el cumplimiento de ciertos objetivos para finales de 2020: ahorrar un 0% de energía en su nivel primario con respecto a 2005; reducir las emisiones de gases de efecto invernadero en un 20% con respecto a 1990; aumentar la energía renovable en el total de la combinación energética a un mínimo del 20% hasta 2020. Al mismo tiempo, la Directiva 2010/31/UE sobre la eficiencia energética de los edificios establece que todos los edificios de nueva construcción deben ser clasificados como "edificios de energía cero" (nZEB) a finales de 2020 y, en el caso de los edificios públicos, a finales de 2018. Dada la preocupación social por mejorar la eficiencia energética en los edificios, considerado como uno de los pilares básicos de las principales estrategias nacionales e internacionales para reducir las emisiones de gases de efecto invernadero, la comunidad científica ha ahondado en esta área contribuyendo con una extensa producción. En el Capítulo II se hace una revisión bibliográfica de la investigación sobre eficiencia energética y sostenibilidad durante el periodo 1976–2016, en el que se estudian algunos de los aspectos claves de las publicaciones como el tipo de documento que predomina, el idioma utilizado, el área de conocimiento en el que más se ha publicado, las principales revistas, palabras clave o autores. Después de haber llevado a cabo una profunda investigación sobre sostenibilidad y eficiencia energética, el Capítulo III analiza la viabilidad de la sustitución de la caldera de gas existente en un edificio universitario del sur de España por la introducción de un sistema de calderas de biomasa. En términos ambientales, la biomasa tiene una clara ventaja sobre los combustibles fósiles, ya que, aunque produce emisiones atmosféricas al quemarse como cualquier otro combustible, estas emisiones se consideran neutras en carbono. Esto se debe a que el dióxido de carbono que emite durante la combustión se compensa con el que absorbe la planta durante su crecimiento, no alterando de esta forma el equilibrio de la concentración de carbono en la atmósfera. Por otra parte, se analizan las propiedades asociadas al hueso de dátil para evaluar su idoneidad como nuevo biocarburante, obteniéndose que este producto de deshecho posee un alto poder calorífico que le confiere unas propiedades óptimas como fuente de energía térmica comparable a otros biocarburantes que se comercializan actualmente. Además, se reduciría unas 95 toneladas de CO2 que son las que emitiría la caldera de gas natural y se obtendría un ahorro económico de más del 66%. En el Capítulo IV se estudia la importante contribución que han realizado diferentes instituciones internacionales en el campo del ahorro energético. Ahorro energético y eficiencia energética son términos relacionados con una reducción del consumo, pero sin embargo existe una importante diferencia. Pues, mientras el ahorro energético conlleva un cambio en los hábitos de consumo, como por ejemplo, apagar las luces al salir de una habitación, la eficiencia energética es el hecho de minimizar la cantidad de energía necesaria para satisfacer la demanda sin afectar a su calidad, sería por ejemplo, sustituir las bombillas existentes por otras que consuman menos energía. No supone, por tanto, cambios en los hábitos de consumo, el comportamiento del usuario, en este caso, sigue siendo el mismo, pero se consume menos energía ya que el consumo energético para llevar a cabo el mismo servicio es menor. Evidentemente, para reducir al máximo el consumo energético habría que aunar medidas de ahorro y eficiencia energética. En este capítulo se realiza un análisis bibliométrico de toda la producción científica indexada en Scopus. La producción científica mundial se analiza en los siguientes ámbitos: En primer lugar, la tendencia en el tiempo, los tipos de publicaciones y países, en segundo lugar, los principales temas y palabras clave, en tercer lugar, las principales instituciones y sus principales temas, y en cuarto lugar, las principales revistas y actas que publican sobre este tema. Luego, estos datos se presentan utilizando algoritmos de detección de comunidades y software de visualización de gráficos. Con estas técnicas es posible determinar las principales áreas de actividad investigadora, así como identificar las estructuras de la red de colaboración en el campo de las energías renovables. Los resultados del trabajo muestran que la literatura en este campo ha aumentado sustancialmente durante los últimos 10 años. Por último, en el Capítulo V se lleva a cabo una revisión energética del Hospital Universitario Reina Sofía de Córdoba, analizando datos de los últimos 3 años. A partir de estos datos se identifican las fuentes de energía actuales y las áreas de uso significativo de la energía y de los equipos con mayores consumos, susceptibles de mejoras energéticas, proponiéndose unas primeras líneas de mejora que irán concretándose con el tiempo. Igualmente se establece una primera línea base energética para este periodo, que podrá tomarse como referencia para el cálculo de ahorro energético, antes y después de implementar las acciones de mejora del desempeño energético. En conclusión, esta Tesis propone la reflexión de la eficiencia energética y el ahorro energético en edificios de uso público, así como de la sostenibilidad de las medidas desde el punto de visto ambiental y económico, profundizando en la producción científica referida a estas líneas de investigación. Al mismo tiempo trata de proporcionar información útil sobre el consumo energético en edificios de uso público y plantear posibles acciones energéticamente eficientes con objeto de evolucionar hacia un nuevo modelo energético más sostenible, sin disminuir la calidad de vida

Analysis of Research Topics and Scientific Collaborations in Energy Saving Using Bibliometric Techniques and Community Detection

Concern about everything related to energy is increasingly latent in the world and therefore the use of energy saving concepts has been increasing over the past several years. The interest in the subject has allowed a conceptual evolution in the scientific community regarding the understanding of the adequate use of energy. The objective of this work is to determine the contribution made by international institutions to the specialized publications in the area of energy-saving from 1939 to 2018, using Scopus Database API Interface. The methodology followed in this research was to perform a bibliometric analysis of the whole scientific production indexed in Scopus. The world’s scientific production has been analysed in the following domains: First the trend over time, types of publications and countries, second, the main subjects and keywords, third, main institutions and their main topics, and fourth, the main journals and proceedings that publish on this topic. Then, these data are presented using community detection algorithms and graph visualization software. With these techniques, it is possible to determine the main areas of research activity as well as to identify the structures of the collaboration network in the field of renewable energy. The results of the work show that the literature in this field have substantially increased during the last 10 years

Worldwide Research on Energy Efficiency and Sustainability in Public Buildings

The present study details the significant contribution that different international institutions have made to the field of sustainability and energy efficiency, with a focus on public buildings. This has been achieved by making use of the database Scopus, by applying bibliometric techniques and by analyzing the contents of articles published from 1976 to 2016. All the materials included in the analysis have been reported from Scopus. Several key aspects of the publications have been considered such as document type, language, subject area, journal type and keywords. Sustainable Development, Sustainability, Energy Conservation, Energy Efficiency and Buildings have been verified as the most used keywords. The obtained contributions have been classified geographically and by institution, with the United States, the United Kingdom, China, Australia and Italy being the leading research countries and Hong Kong Polytechnic University, Delft University of Technology and Tsinghua University the top contributing institutions. The most active categories in those fields are engineering, social sciences and environmental issues in that order. It can be assumed that the study of sustainability and energy efficiency across all its dimensions is of great interest for the scientific community. The global environmental issue has led many countries to incorporate a wide range of Energy Efficiency (EE) strategies in order to reduce energy consumption in public buildings, a highly valued aspect by European Union energy labelling

The use of interactive response systems as a tool to favor proactive learning in Engineering

El desarrollo de las tecnologías de la información y la comunicación (TIC) ha permitido el surgimiento de herramientas didácticas en el campo de la educación, proporcionando herramientas prácticas para apoyar a las clases presenciales. En este contexto, los sistemas electrónicos de respuesta estudiantil pueden ser útiles para introducir un elemento tecnológico motivador en las lecciones, así como una nueva metodología. En este estudio, además del uso de los sistemas de respuesta interactiva o clickers, se ha introducido la tecnología de aprendizaje móvil mediante la elaboración de una metodología de uso de las herramientas Kahoot y Telegram en la asignatura "Fundamentos Físicos en la Ingeniería II" del Grado en Ingeniería Electrónica Industrial. El Departamento de Física Aplicada de la Universidad de Córdoba tiene una amplia experiencia en el uso de Clickers en clases teóricas con grupos grandes para diferentes grados universitarios, pero ahora el uso de tecnologías móviles de aprendizaje se ha introducido en grupos de tamaño medio para clases prácticas. Usando esta nueva metodología, los estudiantes de grupos medianos realizan un cuestionario durante la lección de resolución de problemas, donde utilizaron sus conocimientos adquiridos durante la clase. La realización del cuestionario permite a los profesores evaluar en tiempo real el nivel del estudiante y utilizar la retroalimentación para abordar los problemas iniciales y los malentendidos. Los resultados muestran que los sistemas de respuesta interactiva son altamente valorados por los estudiantes, que lo perciben como una herramienta para mejorar el aprendizaje y aumentar la competencia en el aula.The development of information and communication technologies (ICT) has enabled the emergence of teaching tools in the education field, providing practical tools to support face-to-face classes. In this context, electronic student response systems can be useful for introducing a motivating technological element into the lessons, as well as a new methodology. In this study, in addition to the use of interactive response systems or clickers, mobile learning technology has been introduced by developing a methodology for using the Kahoot and Telegram tools in the subject “Physical Foundations of Engineering II” of Electronic Engineering Degree. Department of Applied Physics of University of Cordoba has a broad experience using Clickers in theory classes with large groups for different university degrees, but now the use of mobile learning technologies has been introduced in medium-sized groups for practical classes. Using this new methodology, students of medium-sized groups perform a quiz during the problem solving lesson, where they utilized their knowledge gained during the class. The completion of the quiz allows teachers to assess the student’s level in real time, and to use the feedback to address initial problems and misunderstandings. Results show the interactive response systems are highly valued by students, who perceive it as a tool to improve learning and increase competition in the classroom

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Analysis of Research Topics and Scientific Collaborations in Energy Saving Using Bibliometric Techniques and Community Detection

Concern about everything related to energy is increasingly latent in the world and therefore the use of energy saving concepts has been increasing over the past several years. The interest in the subject has allowed a conceptual evolution in the scientific community regarding the understanding of the adequate use of energy. The objective of this work is to determine the contribution made by international institutions to the specialized publications in the area of energy-saving from 1939 to 2018, using Scopus Database API Interface. The methodology followed in this research was to perform a bibliometric analysis of the whole scientific production indexed in Scopus. The world&rsquo;s scientific production has been analysed in the following domains: First the trend over time, types of publications and countries, second, the main subjects and keywords, third, main institutions and their main topics, and fourth, the main journals and proceedings that publish on this topic. Then, these data are presented using community detection algorithms and graph visualization software. With these techniques, it is possible to determine the main areas of research activity as well as to identify the structures of the collaboration network in the field of renewable energy. The results of the work show that the literature in this field have substantially increased during the last 10 years

Date seeds (Phoenix dactylifera L.) valorization for boilers in the mediterranean climate

Energy saving is a global priority, as it is helping both energy and environmental sustainability by reducing CO2 emissions. The search for new energy solutions is therefore necessary. In the Mediterranean climate, resources are generally scarce, and all energy sources need to be explored, including biomass from agricultural or industrial waste. There is a clear upward trend in date worldwide production, having doubled its world production in the last 10 years, and this trend is particularly relevant for Mediterranean climate countries, especially in North Africa and nearby countries. This study analyzes the properties associated with the date seed (Phoenix dactylifera L.) to evaluate its suitability and viability as a new biofuel. Specifically, the viability of replacing the existing gas boiler in a university building in the south of Spain with a system of biomass boilers using this biomass was analyzed as a case study. The results reveal that this biomass has HHV values very similar to those of other biomass sources, 19.121 MJ/kg. With the replacement of the gas boiler by a biomass that uses the date seed, a reduction of 95 tons of CO2 per year is obtained and an economic saving of more than 66% is achieved. In short, this work opens new perspectives for the use of this biomass of date seed in boilers and it is an efficient solution for large public buildings such as the buildings of Mediterranean climate universities

EL USO DE LOS SISTEMAS DE RESPUESTA INTERACTIVA COMO HERRAMIENTA PARA FAVORECER EL APRENDIZAJE PROACTIVO EN INGENIERÍA

The development of information and communication technologies (ICT) has enabled the emergence of teaching tools in the education field, providing practical tools to support face-to-face classes. In this context, electronic student response systems can be useful for introducing a motivating technological element into the lessons, as well as a new methodology. In this study, in addition to the use of interactive response systems or clickers, mobile learning technology has been introduced by developing a methodology for using the Kahoot and Telegram tools in the subject “Physical Foundations of Engineering II” of Electronic Engineering Degree. Department of Applied Physics of University of Cordoba has a broad experience using Clickers in theory classes with large groups for different university degrees, but now the use of mobile learning technologies has been introduced in medium-sized groups for practical classes. Using this new methodology, students of medium-sized groups perform a quiz during the problem solving lesson, where they utilized their knowledge gained during the class. The completion of the quiz allows teachers to assess the student’s level in real time, and to use the feedback to address initial problems and misunderstandings. Results show the interactive response systems are highly valued by students, who perceive it as a tool to improve learning and increase competition in the classroom.El desarrollo de las tecnologías de la información y la comunicación (TIC) ha permitido el surgimiento de herramientas didácticas en el campo de la educación, proporcionando herramientas prácticas para apoyar a las clases presenciales. En este contexto, los sistemas electrónicos de respuesta estudiantil pueden ser útiles para introducir un elemento tecnológico motivador en las lecciones, así como una nueva metodología. En este estudio, además del uso de los sistemas de respuesta interactiva o clickers, se ha introducido la tecnología de aprendizaje móvil mediante la elaboración de una metodología de uso de las herramientas Kahoot y Telegram en la asignatura "Fundamentos Físicos en la Ingeniería II" del Grado en Ingeniería Electrónica Industrial. El Departamento de Física Aplicada de la Universidad de Córdoba tiene una amplia experiencia en el uso de Clickers en clases teóricas con grupos grandes para diferentes grados universitarios, pero ahora el uso de tecnologías móviles de aprendizaje se ha introducido en grupos de tamaño medio para clases prácticas. Usando esta nueva metodología, los estudiantes de grupos medianos realizan un cuestionario durante la lección de resolución de problemas, donde utilizaron sus conocimientos adquiridos durante la clase. La realización del cuestionario permite a los profesores evaluar en tiempo real el nivel del estudiante y utilizar la retroalimentación para abordar los problemas iniciales y los malentendidos. Los resultados muestran que los sistemas de respuesta interactiva son altamente valorados por los estudiantes, que lo perciben como una herramienta para mejorar el aprendizaje y aumentar la competencia en el aula

Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p &lt; 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures