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

Bellosta, R.; Piffaretti, G.; Bonardelli, S.; Castelli, P.; Chiesa, R.; Frigerio, D.; Lanza, G.; Pirrelli, S.; Rossi, G.; Trimarchi, S.; Briolini, F.; Cefali, P.; Caronno, R.; Arzini, A.; Diaco, D.; Baratta, V.; Aiello, S.; Molinari, A.C.L.; Giovannini, F.; Socrate, A.M.; Ferraris, M.; Silvestro, A.; Canu, G.; Costantini, E.; Logaldo, D.; Romani, F.; Lista, A.; Busoni, C.; Setti, M.; Mezzetti, R.; Sala, P.; Bassi, L.; Luzzani, L.; Pegorer, M.A.; Attisani, L.; Carugati, C.; Vescovi, M.; Trabattoni, P.; Zoli, S.; Rignano, A.; Magri, C.; Vandone, P.; Losa, S.; Civilini, E.; Nano, G.; Mazzaccaro, D.; Tolva, V.; Lanza, J.; Curci, R.; Simonetti, G.; Lomazzi, C.; Grassi, V.; Bissacco, D.; Kahlberg, A.; Mascia, D.; Dallatana, R.; Carmo, M.; Ragni, F.; Marone, E.M.; Bozzani, A.; Tozzi, M.; Franchin, M.; Lussardi, G.; Segramora, V.; Deleo, G.; Crippa, M.; Porretta, T.; Viani, M.; Stegher, S.; Foresti, D.; Bonalumi, G.

doi:10.1016/j.ejvs.2021.01.037

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.

Regional Survey in Lombardy, Northern Italy, on Vascular Surgery Intervention Outcomes During The COVID-19 Pandemic / R. Bellosta, G. Piffaretti, S. Bonardelli, P. Castelli, R. Chiesa, D. Frigerio, G. Lanza, S. Pirrelli, G. Rossi, S. Trimarchi, F. Briolini, P. Cefali, R. Caronno, A. Arzini, D. Diaco, V. Baratta, S. Aiello, A.C.L. Molinari, F. Giovannini, A.M. Socrate, M. Ferraris, A. Silvestro, G. Canu, E. Costantini, D. Logaldo, F. Romani, A. Lista, C. Busoni, M. Setti, R. Mezzetti, P. Sala, L. Bassi, L. Luzzani, M.A. Pegorer, L. Attisani, C. Carugati, M. Vescovi, P. Trabattoni, S. Zoli, A. Rignano, C. Magri, P. Vandone, S. Losa, E. Civilini, G. Nano, D. Mazzaccaro, V. Tolva, J. Lanza, R. Curci, G. Simonetti, C. Lomazzi, V. Grassi, D. Bissacco, A. Kahlberg, D. Mascia, R. Dallatana, M. Carmo, F. Ragni, E.M. Marone, A. Bozzani, M. Tozzi, M. Franchin, G. Lussardi, V. Segramora, G. Deleo, M. Crippa, T. Porretta, M. Viani, S. Stegher, D. Foresti, G. Bonalumi. - In: EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY. - ISSN 1078-5884. - 61:4(2021 Apr), pp. 688-697. [10.1016/j.ejvs.2021.01.037]