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

Association of Surgeons in Training (ASiT), Irish Surgical Research Collaborative (ISRC), The COVIDSurg Collaborative and Vascular and Endovascular Research Network, VERN Executive Committee, COVIDSurg Operations Committee: Leah ARGUS, COVIDSurg Dissemination Committee, EuroSurg, European Society of Coloproctology (ESCP), GlobalSurg, GlobalPaedSurg, ItSURG, PTSurg, SpainSurg, Italian Society of Colorectal Surgery (SICCR)

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

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 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.

Original languageEnglish (US)
Pages (from-to)558-570
Number of pages13
JournalJournal of Cardiovascular Surgery
Volume62
Issue number6
DOIs
StatePublished - Dec 2021
Externally publishedYes

Keywords

  • COVID-19
  • Health care outcome assessment
  • Vascular surgical procedures

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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