The impact of COVID-19 pandemic on vascular registries and clinical trials

Abstract

Quality improvement programs and clinical trial research experienced disruption due to the coronavirus disease 2019 (COVID-19) pandemic. Vascular registries showed an immediate impact with significant declines in second-quarter vascular procedure volumes witnessed across Europe and the United States. To better understand the magnitude and impact of the pandemic, organizations and study groups sent grass roots surveys to vascular specialists for needs assessment. Several vascular registries responded quickly by insertion of COVID-19 variables into their data collection forms. More than 80% of clinical trials have been reported delayed or not started due to factors that included loss of enrollment from patient concerns or mandated institutional shutdowns, weighing the risk of trial participation on patient safety. Preliminary data of patients undergoing vascular surgery with active COVID-19 infection show inferior outcomes (morbidity) and increased mortality. Disease-specific vascular surgery study collaboratives about COVID-19 were created for the desire to study the disease in a more focused manner than possible through registry outcomes. This review describes the pandemic effect on multiple VASCUNET registries including Germany (GermanVasc), Sweden (SwedVasc), United Kingdom (UK National Vascular Registry), Australia and New Zealand (bi-national Australasian Vascular Audit), as well as the United States (Society for Vascular Surgery Vascular Quality Initiative). We will highlight the continued collaboration of VASCUNET with the Vascular Quality Initiative in the International Consortium of Vascular Registries as part of the Medical Device Epidemiology Network coordinated registry network. Vascular registries must remain flexible and responsive to new and future real-world problems affecting vascular patients.

Fig. 1

(A) UK National Vascular Registry (NVR) and US Vascular Quality Initiative (VQI) comparison: carotid endarterectomy. Weekly number of carotid endarterectomies for first 30 weeks of 2020. Red line denotes week of March 15th. (B) UK NVR and US VQI comparison: infrarenal abdominal aortic aneurysm (AAA) repair. Weekly number of AAA repairs for first 30 weeks of 2020. The red line denotes the week of March 15th. NVR data include elective infrarenal AAA repairs. VQI data include all endovascular aneurysm repair and open procedures.