BACKGROUND: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. METHODS: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. RESULTS: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). CONCLUSION: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic.

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study) / H.V.M. Spiers, O. Kouli, W.U. Ahmed, R. Varley, D. Ahari, L. Argus, K.A. Mclean, S.K. Kamarajah, P. Coe, E.A. Griffiths, A.K.C. Chan, C. Macutkiewicz, S. Jamdar, M. Wilson, C. Fullwood, G. Toogood, O. Kouli, K. Mclean, C. Fullwood, D. Ahari, L. Argus, R. Varley, H.V.M. Spiers, O. Kouli, W. Ahmed, A. Gilchrist, M. Goldsworthy, M. Rashid, P. Pockney, J. Varela, N. Brindl, J. Ramirez, C. Marafante, Y. Iwao, A. Ghzawi, M. Elhadi, H. Gacaferi, C. Varghese, A. Adeyeye, O. Alser, C. Teh, M. Prieto, A. Hasan, H. Al-Naggar, R. Salgado, F. Veracierto, T. Lancelotti, D. Solinas, R. Oddi, F.W. Garcia, E. Mazza Diez, M.R. Andrade Ramirez, R. Bracco, D. Fernandez, M.A. Maraschio, L. Obeide, E. Giordano, A. Alcaraz, M.A. Marani, N. Aguirre, F. Luna, M. Francesconi, F. Chiham, R. Ramos Cossio, F.A. Alvarez, D.A. Pantoja Pachajoa, F. Mandojana, I.G. Merlo, M.H. Gonzalez, G. Cervelo, R. Puma, G.F. Vardaro, A. Davis, D. Jurat, C. Guenoff, K. Raubenheimer, K. Goddard, K. Brown, K.J. Wegrecki, H.Y.C. Cheung, M. Yang, H. Cheung, J. Siddiqui, J.H. Ahn, R. Huynh, Y.H. Lam, M. Afzal, B.S. Ong, M.Y.M. Chua, K. Ly, J.E. Thomson, D. Watson, A.C. Dawson, A. Drane, S. Van Ruyven, E.W.Y. Lun, P. Pockney, M. Ferguson, J.Y. Jeong, C. De Silva, V. Wills, J. Gundara, E. Mccourt, C. Bong, R. Tabone, W.J. Wong, A. Gray, D. Koh, M. Pollock, S. Singhal, R. Smith, N.N. Dudi-Venkata, H. Kanhere, C. Stranz, W. Seow, L.T. Mansour, J. Wormald, B.P.T. Loveday, B. Thomson, T. O'Donnell, N. Milenkovski, M. Herath, M. Trochsler, A. Farfus, G. Maddern, Z. Bunjo, L.L. Kuan, G. Atanasov, A. Dawson, A. Drane, S. Van Ruyven, E. Lun, E. Samadov, I. Namazov, M. Asgarov, A. Ibrahimli, M. Srinivasan, M.F. Saeed, H. Aljawder, I. Juma, F.J. Coimbra, N. Marques, W.A. Casteleins, A. Petruzziello, G. Jabur, J.F.P. Rodriguez, P.L. Buso, S. Mackenzie, M. Hsiao, I. Sljivic, A. Tecson, P.J. Karanicolas, R. Roke, J. Moon, E.V. Butler, F. Riquelme, M. Yanez, F. Catan, M. Uribe, F. Carriel, F. Oppliger, A. Paredes, D. Daroch, J.C. Aguayo, C.J. Perez Rivera, L.M. Acosta Buitrago, A. Kadamani Abiyomaa, M.S. Mosquera Paz, P. Cabrera, J. Corso, N. Ozcay, A. Ozant, K. Arslan, H. Besim, H. Almezghwi, A.Y. Azzam, S. Bessa, I. El-Sayes, A. Badawy, M. Wael, A. El-Gendi, M.A. Azab, M. Fayed, M. El Kassas, M. Gamal, A. Tawheed, A. Al Shafie, S. Emile, A. Elfallal, H. Elfeki, M. Shalaby, A. Sakr, M. Elbahnasawy, M. Shama, W. Abdel-Elsalam, S. Abd-Elsalam, J.E. Escobar Dominguez, F. Medrano, S. Gaitan, O.M. Escalon Gonzalez, J.C. Alfaro Varela, M. Cea, M. Interiano, B. Cabrera, Z. Lakkis, P. Georges, C. Antonot, J. Magnin, C. Kamphues, J.C. Lauscher, C. Schineis, F.N. Loch, L.D. Lee, K. Beyer, K. Bouchagier, I. Galanis, D. Bartziotas, E. Lostoridis, P. Tourountzi, E.A. Nagorni, A. Charalabopoulos, E. Baili, E. Kyros, I. Vagios, A. Skotsimara, T. Liakakos, A. Alexandrou, A. Papalampros, V. Papadopolous, A. Tooulias, I. Kentarchos, C. Christou, G. Tsoulfas, L.F. Tale-Rosales, I. Lopez Muralles, H. Melendez, G. Bran, F.A. Monroy Mahecha, J.R. Contreras, D.E. Porras, E. Paiz, E.R. Soto, J.R. Ixcayau Hernandez, A. Gupta, D. Rajput, N. Kumar, R. Mani, R. Kant, A.A. Sonkar, A. Anand, M.K. Agrawal, K. Gaurav, M. Tripathi, S. Sikora, K. Bharathy, M. Kumar Rangapa, D.S. Khuller, R. Bhojwwani, S. Ayyar, N. Jain, A. Mehraj, F. Hussain, I. Nazir, M. Shah, N.A. Chowdri, A. Hilmi, G. Argenio, P. Atelli, E. Palladino, M.F. Armellino, N. Tamini, L.C. Nespoli, L. Degrate, M. Angrisani, F. Carissimi, P. Bordoni, F. Fleres, P. Bordoni, G. Clarizia, A. Spolini, M. Franzini, E. Cucinotta, G. Badessi, C. Mazzeo, F. Viscosi, G. Pintabona, T. Campagnaro, E. Poletto, G. Turri, A. Ruzzenente, S. Conci, A. Guglielmi, C. Feo, N. Fabbri, M. Fazzin, S. Giaccari, C.V. Feo, M. Massani, P. Pelizzo, M. Colella, R. Tutino, F. Cappellacci, F. Medas, G.L. Canu, E. Erdas, P.G. Calo, A. Porcu, T. Perra, A.M. Scanu, C.F. Feo, A. Fancellu, P. Germani, C. Giunta, A. Biloslavo, H. Abdallah, G. Aizza, A. Barberis, F. Belli, M. Santoliquido, M. Filauro, G. Canonico, T. Nelli, C. Di Martino, L. Capezzuoli, A. Anastasi, L. Bressan, S. Cortinovis, C. Nagliati, F. Colombo, L. Ferrario, A. Bondurri, C. Guerci, A. Maffioli, F. Catena, G. Perrone, M. Giuffrida, A. Morini, A. Annicchiarico, G. Gallo, A. Carpino, F. Ferrari, G. De Paola, G. Sammarco, C. Callari, L. Licari, V. Sorce, D. Di Miceli, F. Lovisetto, S. Zonta, F. Lovisetto, A. Chessa, A. Fiorini, A. De Manzoni Garberini, E. Angelini, C. Marafante, E. Moggia, A. Murgese, S. Mungo, S.L. Birolo, M. Garino, N.S. Pipitone Federico, A. Muratore, E.G. Lunghi, M. Calabro, P. Cianci, R. Enrico, S. Capuzzolo, L. Cafagna, M. Minafra, D. Sasia, A. Gattolin, M. Migliore, R. Rimonda, E. Travaglio, G. De Marco, C. Elter, T. Bargellini, S. D'Amico, D. Zambonin, A. Caponi, G. Calini, A. Puggioni, V. Bresadola, T. Zalla, S. Cantafio, F. Feroci, L. Romoli, R. Giudicissi, A. Picciariello, V. Papagni, R. Dibra, A. Picciariello, D.F. Altomare, E. Pinotti, M. Montuori, G. Baronio, V. Tonini, L. Sartarelli, A. Gori, M. Cervellera, P. Lapolla, P. Sapienza, G. Brachini, B. Cirillo, M. Zambon, A. Mingoli, A. Pascariello, L. Boccia, S. Benedetti, G. Mantovani, M. De Angelis, F. Ferrara, V. Testa, F. Borghi, F. Maione, V. Pruiti Ciarello, G. Giraudo, F. Agresta, G. Cestaro, D. Prando, F. Cavallo, M. Zese, N. Cillara, R. Sechi, R. Cardia, A. Cannavera, G. Putzu, F. Frongia, A. Pisanu, D. Delogu, G. Esposito, M. Podda, A. Iossa, F. De Angelis, C. Boru, G. Silecchia, G.M. Palini, G. Garulli, S. Veneroni, P. Tammaro, P. Maida, P.A. Leake, M.G. Wanliss, Y. Iwao, K. Sato, N. Chiyonobu, H. Imamura, S. Yamazaki, M. Watanabe, A. Qasem, F. Ayasra, S. Al Dahabrh, A. Khaled, S. Alsaafin, A. Al-Thunaibat, D. Olaywah, S. Alqudah, S. Alqawasmi, A. Khamees, A. Guboug, M. Es Salim, T. Althwabteh, H. Bani Khaled, N. El-Hammuri, A. Aljesrawi, F. Alamaadany, M. Eljareh, A.E.J. Al Gasi, S. Alsaeiti, A.S. Alkhafeefi, T. Suliaman, A.H.A. Alanasri, A.B.A. Haroun, A. Haron, A.I. Kilani, M. Ahmed, M. Alawami, A. Alawami, M. Albashri, M. Abusannuga, A. Malek, N. Jwaili, A. Aldenfria, N. Jwaili, F. Elzwawi, A. Almugaddami, A.S.A. Egdeer, M. Masoud, B. Alazzabi, B. Alezabi, A. Shuwayyah, A.A.S. Alkamkhe, I. Aboulqasim, H. Atiyah, R.A.A. Alfagi, A. Abdulmula, A. Bouhuwaish, A. Samer, R. Salim, H. Aboazamazem, B. Almiqlash, M. Biala, W. Alganimi, R. Ghamgh, N. Ben Omar, A. Alsoufi, M. Aldreawi, N. Saleim, F. Sowan, H. Saleem, A. Ahmed, N.E. Samalavicius, O. Aliosin, S. Dailidenas, A. Dulskas, B. Buckus, Z. Kuliesius, R. Bradunaite, I. Dominguez-Rosado, G.A. Buerba, O.E. Posadas-Trujillo, A. Alfaro-Goldaracena, R. Cortes, M.A. Mercado, J.L. Beristain-Hernandez, V.S. Mora-Munoz, J.M. Mena-Bedolla, A.R. Palacios Ramirez, M.M. Astorga Medina, G. Van Aert, S. Ombashi, R. Spillenaar Bilgen, D. Vos, M. Besselink, V. Alberts, O. Busch, W. Bemelman, M. Boermeester, F. Daams, M. Gordinou De Gouberville, P. Van Duijvendijk, M. De Graaff, J. Baaij, S. Gans, K. Bos, B. Goudsmit, B. Den Dekker, A. Braat, A. Kuijpers, S. Breukers, I. Borel Rinkes, D. Andel, T. Hayes, D. Carson, S. Bhat, J. Van Der Have, C. Anderson, I. Bissett, J. Windsor, B.M. Elliott, H. Scowcroft, J. Mclauchlan, D. Ritchie, F. Jeffery, S. Connor, W. Xu, C. Varghese, H. Mashlan, V. Thirayan, J. Ly, M.J. Mcguinness, L. Ferguson, I. Watt, C. Harmston, A. Akinmade, A. Adeyeye, E. Enoch, V. Kayode-Nissi, I. Ogundele, B.A. Ayoade, A. Adekoya, C. Nwokoro, A. Opadeyi, A. Adeyeye, A. Yusuf, A. Ojajuni, O. Adepoju, M. Muhammad Dauda, M. Keffi Mubarak, K. Lawal, D. Muhammad, D. Salonga, N.A. Sael, C.M. Rey, M. Pestano, D. Tan, N.R. Bangayan, D.K. Sy, D. Ang, E. Bernardo, J.P. Chua, M. Alharthi, W. Bukhari, K. Bakier Mohammed, S. Al Athath, M. Ghunaim, H. Saiedi, N. Sultan, A. Farsi, M. Basendowah, M. Alharthi, M. Ghunaim, N. Malibary, H. Jaloun, D. Altalhi, A. Organjee, M. Moamena, T.M. Al Zaidi, M. Alyami, M. Alqannas, M. Al-Urfan, A. Elawad, A. Alawadhi, Y. Alalawi, A. Alqarni, B. Alqahtani, A. Alayed, K. Alsobaie, H. Adi, N. Malibary, M. Elhaj, A. Dehlawi, G. Behairy, I. Khaled, S. Kmezic, D. Radenkovic, L. Aleksic, V. Markovic, I. Pejovic, A. Antic, M. Kalkan, O. Vujanovic Gadjanski, S. Dusan, B. Marcetic, N. Thiruchelvam, A.K.H. Chiow, L.S. Lee, D.Y.C. Mun, E.K. Tan, Y.X. Koh, W.L. Loh, Z. Wang, C.Y. Chan, C. Kloppers, N. Almgla, M. Bernon, M. Kahn, N. Karimbocus, J.I. Roldan Villavicencio, V. Goitia, R.D. Gutierrez Rios, S. Garcia Ruiz, M. Lopez Deogracias, V. Turrado-Rodriguez, X. Morales, A. Hessheimer, R. Termes Serra, J. Beltran De Heredia, J. Trujillo-Diaz, J. Herreros-Rodriguez, M. Montes-Manrique, B. De Andres-Asenjo, J. Beltran-Heredia, T. Gimenez Maurel, A. Utrilla Fornals, L.F. Martin Anoro, S. Cortese, M.D. Perez Diaz, M. Ballon, M. Morote, L. Cebolla Rojas, J.R. Oliver Guillen, A. Lopez De Fernandez, M. Del Campo Lavilla, I. Mora-Guzman, A. Escartin, A. Pinillos, F.F. Vela Polanco, J.H. Jara Quezada, P. Muriel Alvarez, J. Tur-Martinez, J. Camps, E. Herrero, M.I. Garcia-Domingo, E. Cugat Andorra, A. Crespi Mir, O. Claramonte Bellmunt, J.C. Vicens Arbona, I.R. Fernandez Burgos, M. Prieto, A. Sarriugarte Lasarte, H. Marin, M. Tellaeche De La Iglesia, O. Ocerin Alganza, J. Salinas Gomez, P. Ramos-Martin, A. Urbieta, R. Nasimi Sabbagh, J.T. Castell Gomez, A. Serrablo, S. Paterna -Lopez, M. GutiCrossed D SignCopyrightrrez-Diez, M.T. Abadia-Forcen, M. Serradilla-Martin, V.M. Duran Munoz-Cruzado, F. Pareja Ciuro, E. Perea Del Pozo, D. Aparicio Sanchez, S. Dios-Barbeito, B. Marenco De La Cuadra, M. Retamar Gentil, J. Reguera-Rosal, M. Infantes Ormad, J.A. Lopez-Ruiz, A. Landaluce-Olavarria, J.C. Zevallos-Quiroz, J. Barrutia Leonardo, A. Emaldi, E. Begona, I. Balciscueta Coltell, M. Sebastian, S. Martinez Ramos, S. Martinez Alcaide, J. Lorenzo Perez, L.A. Martinez Insfran, P. Lopez-Morales, C. Gimenez Frances, A. Rahy-Martin, M. Pelloni, D. Ortiz-Lopez, O. Benet-Munoz, L. Pinero-Gonzalez, F. Alconchel, T. Nicolas-Lopez, K. Rodrigues, P.A. Cascales Campos, F. Gomez-Bosch, P. Ramirez Romero, M. Ibrahim, H.K.S. Hamid, R. Idres, M. Idris, O. Mohammed, S. Ayran, A.H. Sinan, O. Kouli, V. Ozben, E. Aytac, Z. Aliyeva, A.U. Mutlu, I.A. Bilgin, T. Karahasanoglu, I. Hamzaoglu, B. Bozkirli, T.K. Uprak, T. Kotan, M. Coskun, Y. Kara, E. Somuncu, A. Kocatas, M.A. Bozkurt, S. Demirli Atici, T. Kaya, I. Sert, M. Emiroglu, M. Jaffar, M.U. Younis, T. Aziz, F. Ikram, M. Sandal, F. Al Madhloum Al Suwaidi, M.O. Alshaikh, A. Saber, A. Khammas, A. Nessa, R. Jardine, L. Nicol, C. Clark, A. Mcgee, B. Alkari, M. Feretis, R. Antakia, F. Georgiades, J. Moneim, R. O'Neill, A. Balakrishnan, R. Lunevicius, A. Sud, I. Moutsos, D. Gomez, S. Shahid, T. Majeed, W.K.G. Ibrahim, K. Kadum, R. Melia, C. Magee, D.W. Chicken, S. Kumar, M. Alshibshoubi, S. Van Laarhoven, F. Dewi, J. Williams, B. Byrne, P. Wilkerson, C.B. Tang, N. Farhangmehr, A. Jonas, V. Charavanamuttu, K. Almeida, E. Efthimiou, J. Boardley, A. White, M.A. Butt, D. Menzies, Z. Gundkalli, D. Hassanzadeh-Baboli, O. Jones, P. Mistry, S. Saha, A. Gerrard, J. Evans, S. Rajeev, W. Ali, E. Ross, A. Gilliam, C. Hitchins, K. Emslie, K. Spellar, H. Sked, C. Briggs, L. Brown, N. A Hemadasa, J.R. Apollos, A. Belgaumkar, A. Tawfik, L. Brewin, B. Oyewole, H. Wadhawan, E. Massie, D. Rutherford, K. Mcgivern, L. Mcelroy, H.D. De'Ath, M. Tobbal, S. Nagendram, P. Patel, S. Handa, G. Houghton, S.S. Sundaralingam, J. Parker, R. Morgan, T. Gala, S. Ibrahim, R. Harby, M. Abdelkarim, D. Holroyd, D. Carson, R. Thomas, E. Mclennan, R. Boardley, N.B. Jamieson, H. Ebied, J. Gossage, A. Davies, S. Wheatstone, Z. Jawad, L. Jiao, P. Rajagopal, M. Sodergren, M. Lami, H. Gacaferi, A. Wiberg, G. Bond-Smith, E. Gemmill, E. Lenzi, D. Sapre, P. Herrod, H. Boyd-Carson, G. Garcea, E. Issa, A. Jackson, T. Fashina, H. Pan, B. Farquharson, H. Shafiq, O. Emanuel, S. Mahdi, S. Jeyarajah, L. Finch, G. Whiting, L. Pigott, J. Martin, A.K. Siriwardena, K. Beatson, L. Abawi, W. Lam, W. Rea, B. Andrews, B. Al-Sarireh, F. Soliman, J. Burridge, C. Jenvey, M. Hammoda, M. Hollyman, L. Merker, J. Richards, V. Sukumaran, S. Rogers, C. Payne, S. Bibi, K. Raza, N. Ul Ain, S. Dronamraju, S. Patil, S. Nachimuthu, S. Ravindran, S. Patel, B. Ivanov, M. Patel, F. Ejtehadi, J. Jebamani, M.M. Akhter Rahman, H. Woodun, A. De Prendergast, A. Afzal, E. Bota, A. Gupta, S.R. Abdul, R. Karmarkar, E. Crockett, L. Evans, B. Appleton, E. Griffiths, O. Dada, R. Kulkarni, H. Albirnawi, P. Gravestock, C. Vincenti, S. Taribagil, B. Dent, C. Tse, B. Clayton, E. Burdekin, L. Bannister, I. Alam, J. Gray, M. Mactier, A. Pollock, V. Gough, S.R. Kanchustambam, M. Ridgway, K. Arujunan, S. Gopalswamy, J. Monteiro De Barros, T. Lyons, D. Griffith, A.K. Awan, J. Latif, N. Bandlamudi, I. Bhatti, D.A. Raptis, N. Machairas, T. Pissanou, J. Mestre-Costa, C. Hidalgo Salinas, J.M. Pollok, M. Al-Ardah, A. White, E. Watson-Jones, T. Rontree-Carey, T. Boyce, P. Hawkin, A. Elmaradny, K. Ross, E. Adu-Peprah, K. Pinto, D. Dunne, R. Mccready, G. Nita, P. Szatmary, V.L. Tay, K. Rajput, I. Rajendran, M. Chaudhury, G. Zambas, C. Swaminathan, Q.A.A. Atif, T. Barrow, O. Williams, A. Malik, S. Conroy, S. Lindley, K. Gilmore, E. Boden, S.K. Richards, I. Hraishawi, P. Polak, D. Mclaughlin, D. Deeny, R. Shuttleworth, A. Harris, A. Peilober-Richardson, G.C. Morris, X. Sara, H. Almourad, Y. Ang, R. Smyth, D. Ding, J. Foster, A. Bond, Y. Kumar, A. Ahmad, D. Radoi, A. Alkaili-Alyamani, S. Balakrishnan, R.Y. Satchidanand, A.S. Danwaththa Liyanage, I. Blake, M. Ransome, C. Weerasinghe, C. Kenington, K. Mayo, M. Mohammed, A.J. Cockbain, A. Peckham-Cooper, G. Mccauley, C. Gordon, A. Smith, W. Hawkins, S. Chakravartty, C. Baillie, R. Kenny, A. Kumar, G. Koimtzis, E. Bellamy, A. Menon, A. Kanakala, E.J. Nevins, A. Madhavan, S. Thulasiraman, K. France, A. O'Connor, D. Idama, C. Raslan, S. Sridhar, M. Parveen, T. Mubashar, S. Jarvis, I. Cakmak, C. Wright, S. Andrews, Y. Abdelsaid K Abdul Aal, B. Jayasankar, J. Morilla, M. Shehata, N. Subba, N. Tewari, C. El-Sayed, D. Somaie, N. Beheiry, E. Douka, S. Arumugam, I. Wijetunga, E. Leivers, B. Ibrahim, K. Khan, J. Wheat, J. Christopher, R. Barnett, H. Elberm, J. Booker, S. Ashai, D. Berry, A. Luhmann, A. Sgro, M.M. Rashid, M. Galea, J. Jeyakumar, P. Marriott, S. Zafar, A. Baker, D. Yershov, G. Galanopoulos, A. Gupta, R. Jordan, C. Peinado Garcia, N. Anyaugo, M.F. Bath, J. Evans, J. Omatseye, L. Roberts, E.O. Argyriou, M. Machesney, C. Parmar, S. Clark, H. Khalil, S. Unsworth, M. Mlotshwa, N. Ayoub, A. Aboelkhair, E. Iosif, N. Mohamed, E. Reynolds, E. Mackender, D. Robinson, W. Mufti, K. Fischkoff, N. Coleman, S. Anantha Sathyanarayana, G. Deutsch, M. Giangola, D. Lin, M. Weiss, C. Chung, A. Nguyen, J. Mueller, M. Dabit, J. Gordon, E. Mcguire, O. Rashid, E. Georgi, M. Gallo, J.W. Kunstman, N.V. Peters, R. O'Connor, B. Bhattacharya, E. Onkendi, A.P. Santos, R. Richmond, M. Warren, K. Zhang, R. Broderick, B. Clary, S. Horgan, J. Doucet, A. Liepert, L. Harmon, C. Mccall, J.G. Sham, E. Williams, K.P. Labadie, N.M. Clark, L.K. Dickerson, C.W. Hammill, G. Williams, B. Kushner, H. Cos, J. Zarate Rodriguez, K. Bailey, I.M.N. Al-Raimi, K. Al-Zazay, S. Ahmed Mohammed Al-Mahdi, S. Mohammed Aldowbli, M. Al-Shehari, S. Shream, S. Al-Ameri, M. Aeed, H. Al-Naggar, M. Aldawbali, R. Alsayadi, M. Alsayadi, A.K. Siriwardena. - In: BJS OPEN. - ISSN 2474-9842. - 6:3(2022 Jun 23), pp. zrac052.1-zrac052.11. ((Intervento presentato al 14. convegno International Congress of the European-African-Hepato-Pancreato-Biliary-Association (E-AHPBA) : September tenutosi a (online) nel 2021 [10.1093/bjsopen/zrac052].

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

L. Ferrario
Membro del Collaboration Group
;
C. Guerci
Membro del Collaboration Group
;
G. De Paola
Membro del Collaboration Group
;
G. Mantovani
Membro del Collaboration Group
;
M. Podda
Membro del Collaboration Group
;
A. Menon
Membro del Collaboration Group
;
2022

Abstract

BACKGROUND: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. METHODS: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. RESULTS: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). CONCLUSION: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic.
Cholecystectomy; Humans; Pandemics; SARS-CoV-2; COVID-19; Cholecystitis, Acute
Settore MED/18 - Chirurgia Generale
European African Hepato Pancreato Biliary Association
Article (author)
File in questo prodotto:
File Dimensione Formato  
[029] Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study).pdf

accesso aperto

Tipologia: Publisher's version/PDF
Dimensione 617.1 kB
Formato Adobe PDF
617.1 kB Adobe PDF Visualizza/Apri
zrac088.pdf

accesso aperto

Tipologia: Altro
Dimensione 97.49 kB
Formato Adobe PDF
97.49 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/940716
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 0
  • ???jsp.display-item.citation.isi??? 1
social impact