Nuclear Cardiology in the Post-COVID Era: What Will Be Its Legacy?

The pandemic of Coronavirus disease 2019 (COVID-19) caused a substantial negative impact on patients with cardiovascular disease. The negative impact of the pandemic on daily clinical practices for cardiovascular diseases (CVD) cannot be underestimated. The CVD patients (without COVID-19 infection), whose diagnosis and treatment have been delayed or postponed by the pandemic, are victims of COVID-19. In this context, COVID-19 is a "syndemic" disease. Several studies already revealed that negative changes already occurred in CVD patient management, such as increased in-hospital death, supply shortage of ^99mTc/⁹⁹Mo generator, etc. To clarify the impact of COVID-19 on the management of CVD, a global survey named "INCAPS-COVID" was conducted. This study revealed a substantial reduction (around 50%) of cardiovascular imaging practice in the early stage of the pandemic during March and April 2020. This pandemic has necessitated changes in cardiovascular management practices to adopt this condition. Some of those changes will become the legacy of the pandemic. Possible legacy will be; 1) Use of telemedicine; 2) Shift from exercise to pharmacological stress; 3) Shift from single photon emission computed tomography (SPECT) to positron emission tomography (PET). By adapting and changing to the challenges caused by the COVID-19 pandemic, nuclear cardiology will survive and will rise as an improved cardiovascular practice, even after the pandemic.