Peripheral Artery Disease Causes More Harm to Patients than COVID-19

Kasiri, Mohammad Mahdi; Mittlboek, Martina; Giurgea, Giurgiana-Aura; Fortner, Norbert; Lirk, Phillip; Eilenberg, Wolf; Gollackner, Bernd; Neumayer, Christoph

doi:10.3390/healthcare10101809

Cited by 6 publications

(5 citation statements)

References 23 publications

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“…This reduction in follow-up most likely contributed in a signi cant way to the deterioration of PAD in these patients which eventually lead to them requiring more revascularisation procedures during the pandemic. Indeed a few studies report that patients who presented to hospital with PAD during the pandemic had more severe disease on average compared to pre-pandemic times and required more advanced interventions or even amputations (9)(10)(11)(12).…”

Section: Discussionmentioning

confidence: 99%

The indirect impact of COVID-19 pandemic on limb preservation care– a retrospective analysis of trends in lower limb revascularisation

Anthony

Gillies

Tran

et al. 2023

Preprint

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Background: Disruptions caused by COVID-19 pandemic have profoundly influenced the management of many conditions, especially vascular pathologies including limb preservation care. The aim of this study is to evaluate the impact of the pandemic on patients with peripheral arterial disease (PAD) focusing on lower limb revascularisation procedure volume, their indication and urgency of surgery. Methods: The Australian Vascular Audit (AVA) was used to capture data on revascularisation procedures before and after the onset of the pandemic in Victoria, Australia. Information on patient demographics, procedures performed, their indication and urgency of surgery were collected. Results: There was a significant 22.7% increase in revascularisations for PAD during the COVID-19 pandemic, driven solely by a 31.9% increase in endovascular revascularisation procedures. Endovascular procedures for all indications of PAD, namely claudication, rest pain and tissue loss, increased by 22.3%, 62.9% and 35% respectively, during the pandemic compared to pre-pandemic times. Open procedures declined by 10.2% during the pandemic. There were significant 13.9% and 62.2% increases in elective and semi-urgent revascularisations respectively during the pandemic while emergency revascularisations for PAD fell by 4.2%. Conclusions: This study found that the volume of revascularisation for PAD increased significantly during the pandemic indicating that patients with PAD had significant deterioration of their condition during the pandemic. This is likely multifactorial; due to disruptions to standard provision of podiatry, vascular surgery and endocrinology services to these patients, a decline in overall health and changes in health-related behaviours due to restrictions and infection control methods imposed during the pandemic. The number of elective and semi-urgent procedures also increased during the pandemic which reflects the significant deterioration of PAD patients during the pandemic. This study highlights a concerning trend of worsening PAD when routine care of these patients is disrupted. Such data should be instrumental in contingency planning and resource allocation for managing the ongoing pandemic.

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Section: Discussionmentioning

confidence: 99%

The indirect impact of COVID-19 pandemic on limb preservation care– a retrospective analysis of trends in lower limb revascularisation

Anthony

Gillies

Tran

et al. 2023

Preprint

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“…In terms of trends in procedure volume with respect to lockdown periods, this study found a decline in revascularisation procedures during lockdown periods lasting over 30 days, however, over the longer term, there was an overall increase in revascularisation procedures performed during the pandemic. Previous studies have noted a decline in vascular surgery procedures during the pandemic compared to pre‐pandemic times, but none have investigated the correlation between procedure volume and lockdown periods or the nature of lockdowns [9–12]. Future studies analysing this correlation could aid in developing lockdown strategies that minimise disruptions to healthcare services.…”

Section: Discussionmentioning

confidence: 99%

“…This reduction in follow-up most likely contributed in a significant way to the deterioration of PAD in these patients which eventually lead to them requiring more revascularisation procedures during the pandemic. Indeed a few studies report that patients who presented to hospital with PAD during the pandemic had more severe disease on average compared to pre-pandemic times and required more advanced interventions or even amputations [9][10][11][12]. Another contributing factor to the increase in revascularisations during the pandemic is a general decline in patient health during the pandemic.…”

Section: Discussionmentioning

confidence: 99%

“…Another study from Romania showed a significant decrease in non-urgent vascular surgery during the pandemic [8]. Other studies have also reported that patients with PAD who presented to hospital during the pandemic, often presented with severe disease compared to pre-pandemic times and required more extensive revascularisations [9][10][11][12]. These studies have mainly focused on the first wave of the pandemic.…”

Section: Introductionmentioning

confidence: 99%

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The indirect impact of COVID‐19 pandemic on limb preservation care– a retrospective analysis of trends in lower limb revascularisation

Anthony

Gillies

Tran

et al. 2023

Journal of Foot and Ankle Research

View full text Add to dashboard Cite

Background Disruptions caused by COVID-19 pandemic have profoundly influenced the management of many conditions, especially vascular pathologies including limb preservation care. The aim of this study is to evaluate the impact of the pandemic on patients with peripheral arterial disease (PAD) focusing on lower limb revascularisation procedure volume, their indication and urgency of surgery. Methods The Australian Vascular Audit (AVA) was used to capture data on revascularisation procedures before and after the onset of the pandemic in Victoria, Australia. Information on patient demographics, procedures performed, their indication and urgency of surgery were collected. Results There was a significant 22.7% increase in revascularisations for PAD during the COVID-19 pandemic, driven solely by a 31.9% increase in endovascular revascularisation procedures. Revascularisation procedures for all indications of PAD, namely claudication, rest pain and tissue loss, increased by 14.8%, 39.2% and 27.4% respectively, during the pandemic compared to pre-pandemic times. Open procedures declined by 10.2% during the pandemic. There were significant 13.9% and 62.2% increases in elective and semi-urgent revascularisations respectively during the pandemic while emergency revascularisations for PAD fell by 4.2%. There were no significant increases in toe, forefoot or below knee amputations during the pandemic compared to pre-pandemic times. Conclusions This study found that the volume of revascularisation for PAD increased significantly during the pandemic indicating that patients with PAD had significant deterioration of their condition during the pandemic. This is likely multifactorial; due to disruptions to standard provision of podiatry, vascular surgery and endocrinology services to these patients, a decline in overall health and changes in health-related behaviours due to restrictions and infection control methods imposed during the pandemic. The number of elective and semi-urgent procedures also increased during the pandemic which reflects the significant deterioration of PAD patients during the pandemic. This study highlights a concerning trend of worsening PAD when routine care of these patients is disrupted. Such data should be instrumental in contingency planning and resource allocation for managing the ongoing pandemic.

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“…This may be explained by worse accessibility to diagnostic procedures and therefore lower possibilities for proper vascular disease diagnosis due to pandemic restrictions. Kasiri et al [76] presented an increased number of emergency admissions with unsuccessful revascularization attempts requiring limb amputation, due to pandemic lockdown protocols which limited ability for accurate planned diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Changing Face of Inflammatory Activation in Complex Coronary Artery Disease during the COVID-19 Pandemic

Urbanowicz

Czub

Olasińska-Wiśniewska

et al. 2023

JCDD

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Introduction: The COVID-19 pandemic has changed the immunological status of the population, indicating increased activation. The aim of the study was to compare the degree of inflammatory activation in patients admitted for surgical revascularization in the period before and during the COVID-19 pandemic. Materials and methods: This retrospective analysis included an analysis of inflammatory activation assessed on the basis of whole blood counts in 533 patients (435 (82%) male and 98 (18%) female) with a median age of 66 (61–71) years who underwent surgical revascularization, including 343 and 190 patients operated on in 2018 and 2022, respectively. Results: The compared groups were matched by propensity score matching analysis, obtaining 190 patients in each group. Significantly higher values of preoperative monocyte count (p = 0.015), monocyte-to-lymphocyte ratio (p = 0.004) and systemic inflammatory response index (p = 0.022) were found in the during-COVID subgroup. The perioperative and 12-month mortality rates were comparable, with 1% (n = 4) in 2018 vs. 1% (n = 2) in 2022 (p = 0.911), and 5.6 % (n = 11 patients) vs. 7% (n = 13 patients) (p = 0.413), in the pre-COVID and during-COVID subgroups, respectively. Conclusions: Simple whole blood analysis in patients with complex coronary artery disease performed before and during the COVID-19 pandemic indicates excessive inflammatory activation. However, the immune variation did not interfere with one-year mortality rate after surgical revascularization.

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Peripheral Artery Disease Causes More Harm to Patients than COVID-19

Cited by 6 publications

References 23 publications

The indirect impact of COVID-19 pandemic on limb preservation care– a retrospective analysis of trends in lower limb revascularisation

The indirect impact of COVID-19 pandemic on limb preservation care– a retrospective analysis of trends in lower limb revascularisation

The indirect impact of COVID‐19 pandemic on limb preservation care– a retrospective analysis of trends in lower limb revascularisation

Changing Face of Inflammatory Activation in Complex Coronary Artery Disease during the COVID-19 Pandemic

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