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ORIGINAL ARTICLE  COVID OUTBREAK AND VASCULAR DISEASES Free accessfree

The Journal of Cardiovascular Surgery 2021 December;62(6):558-70

DOI: 10.23736/S0021-9509.21.12024-5

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Impact of COVID-19 on vascular patients worldwide: analysis of the COVIDSurg data

Louise HITCHMAN 1 , Matthew MACHIN 2, on behalf of The COVIDSurg Collaborative and Vascular and Endovascular Research Network 

1 Academic Vascular Surgical Unit, Hull Royal Infirmary, Hull, UK; 2 Department of Surgery and Cancer, Imperial College London, London, UK



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 COVER study 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.


KEY WORDS: COVID-19; Vascular surgical procedures; Health care outcome assessment

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