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

Hitchman, Louise, Machin, Matthew, The COVIDSurg Collaborative and Vascular and Endovascular, Research Network and Bosanquet, David ORCID: https://orcid.org/0000-0003-2304-0489 2021. Impact of COVID-19 on vascular patients worldwide: analysis of the COVIDSurg data. Journal of Cardiovascular Surgery 62 (6) , pp. 558-570. 10.23736/s0021-9509.21.12024-5

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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.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Additional Information:	David Bosanquet is a member of the VERN Executive Committee
Publisher:	Edizioni Minerva Medica
ISSN:	0021-9509
Date of Acceptance:	13 October 2021
Last Modified:	01 Jul 2024 11:45
URI:	https://orca.cardiff.ac.uk/id/eprint/169996

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