key: cord-0974743-e8h2mk57
authors: Martelli, Eugenio; Sotgiu, Giovanni; Saderi, Laura; Martelli, Allegra Rosa; Settembrini, Alberto Maria
title: The impact of the first eleven months of the COVID-19 pandemic on vascular patients’ care and hospitalization rate in the Vascular Surgery Divisions of Southern Italy
date: 2022-04-26
journal: Eur J Vasc Endovasc Surg
DOI: 10.1016/j.ejvs.2022.04.021
sha: 8db10313b8018be780b7ffe9ce162203e0c0513e
doc_id: 974743
cord_uid: e8h2mk57

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The numbers of endovascular abdominal aneurysm repair or open repair for asymptomatic AAA, treatment for venous ulcers, and severe ICA stenosis >80% according to ECST on operation waiting list complicated to total obstruction (detected at duplex control before revascularization, or because become symptomatic) did not change throughout the study period.

Our multicenter study, covering more than one-fifth of the Italian geographical area and population over a long time-period, showed decreased rates of revascularization for R3PAD and asymptomatic ICA stenosis, as well as increased rates of revascularization (or major amputation) for CLTI and symptomatic ICA stenosis.

Interestingly, in January 2021 (when the immediate pandemic restrictions were lifted) a major decrease of R3PAD and asymptomatic ICA stenosis persisted compared to pre-pandemic levels [92 (11.37%) and 87 (10.75% vs 175 (16.75%) and 164 (15.69%), p=0.001 and 0.002, respectively]. Our analysis suggests that the delays may have further consequences in the coming months. This may be due to shortage of staff, burnout, but also COVID infections. Project 1 (Impact of COVID-19 on scheduled vascular operations) of the international Vascular Surgery COVID-19 Collaborative (VASCC) registry aims to answer this particular question. VASCC is a combined international effort to obtain prospective data on the impact of widespread vascular surgical care delays due to an international crisis or pandemic. 1, 2 Changes during the COVID-19 pandemic could have affected patient prognosis. Several researchers, clinicians, and policymakers have been trying to understand the real impact of the pandemic on clinical activities. 3, 4 Several study limitations can be highlighted. We don't know the exact numbers, since patients may not have visited any medical service during these periods. Some vascular diseases were not considered: complex aortic procedures are often referred to specialist centers, and we believed numbers would have been too low to be considered; arteriovenous fistulas are also performed by nephrologists; likewise, varicose vein surgery was excluded based on its postponement caused by their low priority. We evaluated only the first eleven months of the COVID-19 pandemic against the corresponding 2019 months; as such, inter-annual variability cannot be excluded. The stratification of the findings based on SARS-CoV-2 positivity was not always performed: the infection could have increased the incidence of some vascular diseases (e.g., DVT). 

The Vascular Surgery COVID-19

Collaborative (VASCC)

Vascular Surgery COVID-19 Collaborative" (VASCC)

Vascular Surgery During COVID-19 Emergency in Hub Hospitals of Lombardy: Experience on 305 Patients

Regular Vascular Practice During the COVID-19 Pandemic?

The authors received no funding for this study and declare no conflict of interest.The authors gratefully acknowledge Edoardo Guarino, M Eng, M Sc, for the English revision of this manuscript.