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Review
. 2025 Feb 25;20(1):16.
doi: 10.1186/s13017-025-00591-w.

COVID-19 infection is a significant risk factor for death in patients presenting with acute cholecystitis: a secondary analysis of the ChoCO-W cohort study

Belinda De Simone  1   2 , Fikri M Abu-Zidan  3 , Lucienne Kasongo  4 , Ernest E Moore  5 , Mauro Podda  6 , Massimo Sartelli  7 , Arda Isik  8 , Miklosh Bala  9 , Raul Coimbra  10 , Zsolt J Balogh  11 , Kemal Rasa  12 , Francesco Marchegiani  13 , Carlo Alberto Schena  14 , Nicola DèAngelis  14 , Marcello Di Martino  15   16 , Luca Ansaloni  17 , Federico Coccolini  18 , Andrew A Gumbs  19 , Walter L Biffl  20 , Emmanouil Pikoulis  21 , Nikolaos Pararas  21 , Elie Chouillard  22 ; ChoCO Collaborative group; Fausto Catena  23   24
Collaborators, Affiliations
Review

COVID-19 infection is a significant risk factor for death in patients presenting with acute cholecystitis: a secondary analysis of the ChoCO-W cohort study

Belinda De Simone et al. World J Emerg Surg. .

Abstract

Background: During the coronavirus disease (COVID-19) pandemic, there has been a surge in cases of acute cholecystitis. The ChoCO-W global prospective study reported a higher incidence of gangrenous cholecystitis and adverse outcomes in COVID-19 patients. Through this secondary analysis of the ChoCO-W study data, we aim to identify significant risk factors for mortality in patients with acute cholecystitis during the COVID-19 pandemic, emphasizing the role of COVID-19 infection in patient outcomes and treatment efficacy."

Methods: The ChoCO-W global prospective study reported data from 2546 patients collected at 218 centers from 42 countries admitted with acute cholecystitis during the COVID-19 pandemic, from October 1, 2020, to October 31, 2021. Sixty-four of them died. Nonparametric statistical univariate analysis was performed to compare patients who died and patients who survived. Significant factors were then entered into a logistic regression model to define factors predicting mortality.

Results: The significant independent factors that predicted death in the logistic regression model with were COVID-19 infection (p < 0.001), postoperative complications (p < 0.001), and type (open/laparoscopic) of surgical intervention (p = 0.003). The odds of death increased 5 times with the COVID-19 infection, 6 times in the presence of complications, and it was reduced by 86% with adequate source control. Survivors predominantly underwent urgent laparoscopic cholecystectomy (52.3% vs. 23.4%).

Conclusions: COVID-19 was an independent risk factor for death in patients with acute cholecystitis. Early laparoscopic cholecystectomy has emerged as the cornerstone of treatment for hemodynamically stable patients.

Trial registration: ClinicalTrials.gov NCT04542312.

Keywords: Acute cholecystitis; Covid-19; Emergency; Laparoscopic cholecystectomy; Management; Mortality; Sars-CoV-2.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethical committee approval for this ChoCO-W study was obtained from CPP Sud-Méditerranée 3, University Hospital of Nîmes-France (2021.03.05 ter _ 21.01.16.09406). Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Gangrenous cholecystitis
See this image and copyright information in PMC

References

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