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

Hitchman, Louise; Machin, Matthew

Abstract

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.

Citation

Hitchman, L., & Machin, M. (2021). Impact of COVID-19 on vascular patients worldwide: analysis of the COVIDSurg data. Journal of Cardiovascular Surgery, 62(6), 558-70. https://doi.org/10.23736/S0021-9509.21.12024-5

• Journal Article Type: Article
• Acceptance Date: Oct 13, 2021
• Publication Date: 2021-12
• Deposit Date: Jan 25, 2022
• Publicly Available Date: Jan 1, 2023
• Journal: Journal of Cardiovascular Surgery
• Publisher: Edizioni Minerva Medica
• Peer Reviewed: Peer Reviewed
• Volume: 62
• Issue: 6
• Pages: 558-70
• DOI: https://doi.org/10.23736/S0021-9509.21.12024-5
• Keywords: COVID-19; Vascular surgical procedures; Health care outcome assessment
• Public URL: https://hull-repository.worktribe.com/output/3916776
• Additional Information: Free access on publisher website (Feb 2022)