Outcomes of Vascular and Endovascular Interventions Performed During the Coronavirus Disease 2019 (COVID-19) Pandemic: The Vascular and Endovascular Research Network (VERN) Covid-19 Vascular Service (COVER) Tier 2 Study

Ruth A Benson*, Graeme K Ambler, Vascular and Endovascular Research Network (VERN) Collaborators

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

OBJECTIVE: The aim of the COVER Study is to identify global outcomes and decision making for vascular procedures during the pandemic.

BACKGROUND DATA: During its initial peak, there were many reports of delays to vital surgery and the release of several guidelines advising later thresholds for vascular surgical intervention for key conditions.

METHODS: An international multi-centre observational study of outcomes following open and endovascular interventions.

RESULTS: In an analysis of 1,103 vascular intervention (57 centres in 19 countries), 71.6% were elective or scheduled procedures. Mean age was 67 ± 14 years (75.6% male). Suspected or confirmed COVID-19 infection was documented in 4.0%. Overall, in-hospital mortality was 11.0%. (aortic interventions mortality 15.2% [23/151], amputations 12.1% [28/232], carotid interventions 10.7% [11/103], lower limb revascularisations 9.8% [51/521]). Chronic obstructive pulmonary disease (Odds ratio [OR] 2.02, 95% CI 1.30-3.15) and active lower respiratory tract infection due to any cause (OR 24.94, 95% CI 12.57-241.70) ware associated with mortality, whereas elective or scheduled cases were lower risk (OR 0.4, 95% CI 0.22-0.73 and 0.60, 95% CI 0.45-0.98 respectively. After adjustment, antiplatelet (Odds Ratio [OR] 0.503, 95% Confidence Interval [CI]:0.273 - 0.928) and oral anticoagulation (OR 0.411, 95% CI: 0.205 - 0.824) were linked to reduced risk of in-hospital mortality.

CONCLUSIONS: Mortality following vascular interventions during this period was unexpectedly high. Suspected or confirmed COVID-19 cases were uncommon. Therefore an alternative cause e.g. recommendations for delayed surgery, should be considered. The vascular community must anticipate longer term implications for survival.

Original languageEnglish
JournalAnnals of Surgery
Early online date23 Dec 2020
DOIs
Publication statusE-pub ahead of print - 23 Dec 2020

Structured keywords

  • Covid19

Cite this