Outcomes of acute limb ischemia in COVID-19

Pham, Antoine; Heib, Adele; Goodman, Elliot R.; Lipsitz, Evan C.; Indes, Jeffrey

doi:10.1016/j.jvs.2022.04.038

Cited by 8 publications

(19 citation statements)

References 25 publications

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“…The systematic review of the literature collected 11 different studies, for a total of 15,803 patients. Seven of these were retrospective studies [22,[27][28][29][30][31][32], three were prospective [33][34][35], while one [36] was a prospective study that included a comparison group formed by a retrospectively collected cohort.…”

Section: Description Of Included Studies In the Systematic Reviewmentioning

confidence: 99%

“…Five studies [27,29,31,32,36] included as a comparison group a cohort of pre-COVID patients, who had been treated for ALI in the period between 2017 and 2019. Four further studies, [22,30,33,34] considered for comparisons negative patients treated concurrently as COVID-19-positive patients. The study by Goldman et al [27] included both a pre-COVID-19 group and patients who tested SARS-CoV-2 negative during the period from January 2020 to April 2020.…”

Section: Description Of Included Studies In the Systematic Reviewmentioning

confidence: 99%

“…It has been suggested that patients with COVID-19-induced ALI may suffer an increased rate of negative outcomes, (i.e., higher amputation rates and mortality) [22], and that ALI may significantly affect even younger patients with a lower burden of comorbidities [23].…”

Section: Introductionmentioning

confidence: 99%

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The Impact of COVID-19 on Amputation and Mortality Rates in Patients with Acute Limb Ischemia: A Systematic Review and Meta-Analysis

Crupi,

Ardizzone,

Calapai

et al. 2024

Diseases

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Since the inception of the SARS-CoV-2 pandemic, healthcare systems around the world observed an increased rate of Acute Limb Ischemia (ALI) in patients with a COVID-19 infection. Despite several pieces of evidence suggesting that COVID-19 infection may also worsen the prognosis associated with ALI, only a small number of published studies include a direct comparison regarding the outcomes of both COVID-19 and non-COVID-19 ALI patients. Based on the above, a systematic review and a meta-analysis of the literature were conducted, evaluating differences in the incidence of two major outcomes (amputation and mortality rate) between patients concurrently affected by COVID-19 and negative ALI subjects. PubMed (MEDLINE), Web of Science, and Embase (OVID) databases were scrutinized from January 2020 up to 31 December 2023, and 7906 total articles were recovered. In total, 11 studies (n: 15,803 subjects) were included in the systematic review, and 10 of them (15,305 patients) were also included in the meta-analysis. Across all the studies, COVID-19-positive ALI patients experienced worse outcomes (mortality rates ranging from 6.7% to 47.2%; amputation rates ranging from 7.0% to 39.1%) compared to non-infected ALI patients (mortality rates ranging from 3.1% to 16.7%; amputation rates ranging from 2.7% to 18%). Similarly, our meta-analysis shows that both the amputation rate (OR: 2.31; 95% CI: 1.68–3.17; p < 0.00001) and mortality (OR: 3.64; 95% CI: 3.02–4.39; p < 0.00001) is significantly higher in COVID-19 ALI patients compared to ALI patients.

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Section: Description Of Included Studies In the Systematic Reviewmentioning

confidence: 99%

Section: Description Of Included Studies In the Systematic Reviewmentioning

confidence: 99%

See 1 more Smart Citation

The Impact of COVID-19 on Amputation and Mortality Rates in Patients with Acute Limb Ischemia: A Systematic Review and Meta-Analysis

Crupi,

Ardizzone,

Calapai

et al. 2024

Diseases

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show abstract

“…122 A study that aimed to study outcomes in lower extremity acute limb ischemia between January 20, 2020 and May 20, 2021, using data from 63 US health care organizations via TriNetX's COVID-19 Research Network platform found that there was a higher proportion of Hispanic patients and a lower proportion of white patients admitted with acute limb ischemia who were COVID-19 positive compared with COVID-19 negative, respectively. 123 In a study that utilized the Secondary Uses Service data set that examined all major and minor lower-limb amputation and revascularization procedures in people with diabetes in England between January 1, 2017 and October 31, 2020, rates of major amputations were 7% (95% CI, −0.7 to 14) lower, minor amputations were 21% (95% CI, 17-25) lower, and revascularization procedures were 23% (95% CI, 20-26) lower when compared with means from the equivalent time periods between 2017 and 2019. 124 From March to June 2020, there were higher proportions of men and those of white race who underwent all procedures, but these data were "similar to previous years.…”

Section: Pad the Covid-19 Pandemic And Disparitiesmentioning

confidence: 99%

Section: Pad the Covid-19 Pandemic And Disparitiesmentioning

confidence: 99%

Sex and Racial Disparities in Peripheral Artery Disease

Divakaran,

Krawisz,

Secemsky

et al. 2023

ATVB

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Several studies have shown that women and racial and ethnic minority patients are at increased risk of developing lower extremity peripheral artery disease and suffering adverse outcomes from it, but a knowledge gap remains regarding the underlying causes of these increased risks. Both groups are more likely to be underdiagnosed, have poorly managed contributory comorbidities, and incur disparities in treatment and management postdiagnosis. Opportunities for improvement in the care of women and racial and ethnic minorities with peripheral artery disease include increased rates of screening, higher rates of clinical suspicion (particularly in the absence of typical symptoms of intermittent claudication), and more aggressive risk factor management before and after the diagnosis of peripheral artery disease.

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