Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021 Apr;61(4):688-697.
doi: 10.1016/j.ejvs.2021.01.037. Epub 2021 Mar 13.

Regional Survey in Lombardy, Northern Italy, on Vascular Surgery Intervention Outcomes During The COVID-19 Pandemic

Raffaello Bellosta  1 , Gabriele Piffaretti  2 , Stefano Bonardelli  3 , Patrizio Castelli  4 , Roberto Chiesa  5 , Dalmazio Frigerio  6 , Gaetano Lanza  7 , Stefano Pirrelli  8 , Giovanni Rossi  9 , Santi Trimarchi  10 ; Lombardy Covid-19 Vascular Study Group
Collaborators, Affiliations
Observational Study

Regional Survey in Lombardy, Northern Italy, on Vascular Surgery Intervention Outcomes During The COVID-19 Pandemic

Raffaello Bellosta et al. Eur J Vasc Endovasc Surg. 2021 Apr.

Abstract

Objective: The characteristics and outcomes of patients undergoing vascular surgery hospitalised and managed in Lombardy are described with a comparison of patients tested positive for COVID-19 (CV19-pos) vs. those tested negative (CV19-neg).

Methods: This was a multicentre, retrospective, observational cohort study which involved all vascular surgery services in Lombardy, Northern Italy. Data were retrospectively merged into a combined dataset covering the nine weeks of the Italian COVID-19 pandemic phase 1 (8 March 2020 to 3 May 2020). The primary outcome was freedom from in hospital death, secondary outcomes were re-thrombosis rate after peripheral revascularisation, and freedom from post-operative complication.

Results: Among 674 patients managed during the outbreak, 659 (97.8%) were included in the final analysis: 121 (18.4%) were CV19-pos. CV19-pos status was associated with a higher rate of complications (OR 4.5; p < .001, 95% CI 2.64 - 7.84), and a higher rate of re-thrombosis after peripheral arterial revascularisation (OR 2.2; p = .004, 95% CI 1.29 - 3.88). In hospital mortality was higher in CV19-pos patients (24.8% vs. 5.6%; OR 5.4, p < .001;95% CI 2.86 - 8.92). Binary logistic regression analysis identified CV19-pos status (OR 7.6; p < .001, 95% CI 3.75 - 15.28) and age > 80 years (OR 3.2; p = .001, 95% CI 1.61 - 6.57) to be predictors of in hospital death.

Conclusion: In this experience of the vascular surgery group of Lombardy, COVID-19 infection was a marker of poor outcomes in terms of mortality and post-operative complications for patients undergoing vascular surgery treatments.

Keywords: COVID-19; acute limb ischaemia; vascular surgery activities.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Consort diagram of patients hospitalised and managed in the vascular surgery units of the Lombardy region during phase one of the COVID-19 outbreak (8 March 2020 to 3 May 2020).
Figure 2
Figure 2
Flow diagram of 307 patients who underwent revascularisation for peripheral arterial occlusive disease patients in Lombardy, Italy, during the COVID-19 (CV19) pandemic. ALI = acute limb ischaemia; CLTI = chronic limb threatening ischaemia.
Figure 3
Figure 3
Receiver operating characteristic (ROC) curve analysis for mortality predictors (positivity for COVID-19 [CV19] and age > 80 years) among 659 vascular surgery patients in Lombardy, Italy. AUROC = area under the ROC curve.
See this image and copyright information in PMC

Comment in

References

    1. Wu Z., McGoogan J.M. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323:1239–1242. - PubMed
    1. Guan W.J., Ni Z.Y., Hu Y., Liang W.H., Ou C.Q., He J.X., et al. China Medical Treatment Expert Group for Covid-19 Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382:1708–1720. - PMC - PubMed
    1. Piccolo R., Bruzzese D., Mauro C., Aloia A., Baldi C., Boccalatte M., et al. Population trends in rates of percutaneous coronary revascularization for acute coronary syndromes associated with the COVID-19 outbreak. Circulation. 2020;141:2035–2037. - PMC - PubMed
    1. Hendren N.S., Drazner M.H., Bozkurt B., Cooper L.T., Jr. Description and proposed management of the acute COVID-19 cardiovascular syndrome. Circulation. 2020;141:1903–1914. - PMC - PubMed
    1. Poissy J., Goutay J., Caplan M., Parmentier E., Duburcq T., Lassalle F., et al. Lille ICU Haemostasis COVID-19 group Pulmonary embolism in COVID-19 patients: awareness of an increased prevalence. Circulation. 2020;142:184–186. - PubMed

Publication types