TY - JOUR
T1 - Impact of COVID-19 on vascular patients worldwide
T2 - Analysis of the COVIDSurg data
AU - The COVIDSurg Collaborative and Vascular and Endovascular Research Network
AU - VERN Executive Committee
AU - COVIDSurg Operations Committee: Leah ARGUS
AU - COVIDSurg Dissemination Committee
AU - EuroSurg
AU - European Society of Coloproctology (ESCP)
AU - GlobalSurg
AU - GlobalPaedSurg
AU - ItSURG
AU - PTSurg
AU - SpainSurg
AU - Italian Society of Colorectal Surgery (SICCR)
AU - Association of Surgeons in Training (ASiT)
AU - Irish Surgical Research Collaborative (ISRC)
AU - Hitchman, Louise
AU - Machin, Matthew
AU - Ambler, Graeme
AU - Benson, Ruth
AU - Birmpili, Panagiota
AU - Blair, Robert
AU - Bosanquet, David
AU - Dattani, Nikesh
AU - Dovell, George
AU - Forsythe, Rachael
AU - Gwilym, Brenig
AU - Hitchman, Louise
AU - Machin, Matthew
AU - Nandhra, Sandip
AU - Onida, Sarah
AU - Preece, Ryan
AU - Salim, Joseph S.
AU - Saratzis, Thanos
AU - Shalhoub,
AU - Singh, Aminder
AU - Argus, Leah
AU - Bhangu, Aneel
AU - Chaudhry, Daoud
AU - Dawson, Brett E.
AU - Glasbey, James C.
AU - Gujjuri, Rohan R.
AU - Jones, Conor S.
AU - Kamarajah, Sivesh K.
AU - Khatri, Chetan
AU - Keatley, James M.
AU - Lawday, Samuel
AU - Li, Elizabeth
AU - Mann, Harvinder
AU - Marson, Ella J.
AU - McLean, Kenneth A.
AU - Nepogodiev, Dmitri
AU - Picciochi, Maria
AU - Siaw-Acheampong, Kwabena
AU - Simoes, Joana F.
AU - Taylor, Elliott H.
AU - Tiwari, Abhinav
AU - Trout, Isobel M.
AU - Venn, Mary L.
AU - Wilkin, Richard J.
AU - Abbott, Tom E.
AU - Abukhalaf, Sadi
AU - Ademuyiwa, Adesoji
AU - Adil, Ahmed
AU - Ahmed, K.
AU - Alvi, A.
N1 - Publisher Copyright:
© 2021 Edizioni Minerva Medica. All rights reserved.
PY - 2021/12
Y1 - 2021/12
N2 - BACKGROUND: The COVIDSurg collaborative was an international multicenter prospective analysis of perioperative data from 235 hospitals in 24 countries. It found that perioperative COVID-19 infection was associated with a mortality rate of 24%. At the same time, the COVERstudy demonstrated similarly high perioperative mortality rates in vascular surgical patients undergoing vascular interventions even without COVID-19, likely associated with the high burden of comorbidity associated with vascular patients. This is a vascular subgroup analysis of the COVIDSurg cohort. METHODS: All patients with a suspected or confirmed diagnosis of COVID-19 in the 7 days prior to, or in the 30 days following a vascular procedure were included. The primary outcome was 30-day mortality. Secondary outcomes were pulmonary complications (adult respiratory distress syndrome, pulmonary embolism, pneumonia and respiratory failure). Logistic regression was undertaken for dichotomous outcomes. RESULTS: Overall, 602 patients were included in this subgroup analysis, of which 88.4% were emergencies. The most common operations performed were for vascular-related dialysis access procedures (20.1%, N.=121). The combined 30-day mortality rate was 27.2%. Composite secondary pulmonary outcomes occurred in half of the vascular patients (N.=275, 45.7%). CONCLUSIONS: Mortality following vascular surgery in COVID positive patients was significantly higher than levels reported pre-pandemic, and similar to that seen in other specialties in the COVIDSurg cohort. Initiatives and surgical pathways that ensure vascular patients are protected from exposure to COVID-19 in the peri-operative period are vital to protect against excess mortality.
AB - BACKGROUND: The COVIDSurg collaborative was an international multicenter prospective analysis of perioperative data from 235 hospitals in 24 countries. It found that perioperative COVID-19 infection was associated with a mortality rate of 24%. At the same time, the COVERstudy demonstrated similarly high perioperative mortality rates in vascular surgical patients undergoing vascular interventions even without COVID-19, likely associated with the high burden of comorbidity associated with vascular patients. This is a vascular subgroup analysis of the COVIDSurg cohort. METHODS: All patients with a suspected or confirmed diagnosis of COVID-19 in the 7 days prior to, or in the 30 days following a vascular procedure were included. The primary outcome was 30-day mortality. Secondary outcomes were pulmonary complications (adult respiratory distress syndrome, pulmonary embolism, pneumonia and respiratory failure). Logistic regression was undertaken for dichotomous outcomes. RESULTS: Overall, 602 patients were included in this subgroup analysis, of which 88.4% were emergencies. The most common operations performed were for vascular-related dialysis access procedures (20.1%, N.=121). The combined 30-day mortality rate was 27.2%. Composite secondary pulmonary outcomes occurred in half of the vascular patients (N.=275, 45.7%). CONCLUSIONS: Mortality following vascular surgery in COVID positive patients was significantly higher than levels reported pre-pandemic, and similar to that seen in other specialties in the COVIDSurg cohort. Initiatives and surgical pathways that ensure vascular patients are protected from exposure to COVID-19 in the peri-operative period are vital to protect against excess mortality.
KW - COVID-19
KW - Health care outcome assessment
KW - Vascular surgical procedures
UR - http://www.scopus.com/inward/record.url?scp=85123568915&partnerID=8YFLogxK
U2 - 10.23736/S0021-9509.21.12024-5
DO - 10.23736/S0021-9509.21.12024-5
M3 - Article
C2 - 35037445
AN - SCOPUS:85123568915
SN - 0021-9509
VL - 62
SP - 558
EP - 570
JO - Journal of Cardiovascular Surgery
JF - Journal of Cardiovascular Surgery
IS - 6
ER -