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Multicenter Study
. 2022 Jul;23(4):532-537.
doi: 10.1177/1129729821997252. Epub 2021 Feb 23.

Retrospective survey from vascular access team Lombardy net in COVID-19 era

Antonio Gidaro  1 , Davide Vailati  2 , Marco Gemma  3 , Francesca Lugli  1 , Francesco Casella  1 , Chiara Cogliati  1 , Antonio Canelli  2 , Nadia Cremonesi  2 , Davide Monolo  4 , Giuseppe Cordio  4 , Chiara Frosi  4 , Riccardo Destefanis  5 , Anna Rossi  5 , Maria Chiara Alemanno  6 , Franco Valenza  6 , Mara Dina Luisoni  6 , Stefano Elli  7 , Andrea Caldarini  7 , Alberto Lucchini  7 , Stefano Paglia  8 , Monica Baroni  8 , Davide Giustivi  8
Affiliations
Multicenter Study

Retrospective survey from vascular access team Lombardy net in COVID-19 era

Antonio Gidaro et al. J Vasc Access. 2022 Jul.

Abstract

Background: Venous Access Devices (VADs) are the most used devices in COVID-19 patients.

Objective: Identify VADs implanted, catheter related thrombosis (CRT), catheter-related bloodstream infection (CRBSI), and accidental remove of VADs in both COVID-19 positive and COVID-19 free patients. Successive analysis was conducted comparing COVID-19 positive patients with COVID-19 free with inverse probability propensity score weights using simple regression to account for these two confounders (peripheral tip as central/peripheral and hospitalization as no/yes).

Methods: This multicenter, retrospective cohort study collected data from seven hospitals in Lombardy during the pandemic period from February 21st to May 31st 2020.

Results: A total of 2206 VADs were evaluated, 1107 (50.2%) of which were inserted in COVID-19 patients. In COVID-19 cohort the first choice was Long Peripheral Cannula in 388 patients (35.1%) followed by Midline Catheter in 385 (34.8%). The number of "central tip" VADs inserted in COVID-free inpatients and COVID-19 positive were similar (307 vs 334). We recorded 42 (1.9%) CRT; 32 (79.2%) were observed in COVID-19 patients. A total of 19 CRBSI were diagnosed; 15 (78.95%) were observed in COVID-19. Accidental removals were the more represented complication with 123 cases, 85 (69.1%) of them were in COVID-19. COVID-19 significantly predicted occurrence of CRT (OR = 2.00(1.85-5.03); p < 0.001), CRSB (OR = 3.82(1.82-8.97); p < 0.001), and Accidental Removal (OR = 2.39(1.80-3.20); p < 0.001) in our propensity score weighted models.

Conclusions: CRT, CRBSI, and accidental removal are significantly more frequent in COVID-19 patients. Accidental removals are the principal complication, for this reason, the use of subcutaneously anchored securement is recommended for a shorter period than usual.

Keywords: COVID-19; Venous access devices; accidental remove; catheter related thrombosis; catheter-related bloodstream infection.

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