Retrospective survey from Vascular Access Team Lombardy Net in COVID-19 era

Abstract

Background: Venous Access Devices (VADs) are the most used device in COVID-19 patients. To the best of our knowledge this is first survey on VADs in COVID-19 era. Objective: Identify catheter related thrombosis (CRT), catheter-related bloodstream infection (CRBSI), and accidental remove of VADs in both COVID-19 positive and COVID-19 free patients. Successive analysis was conducted comparing COVID-19 positive patients with COVID-19 free with inverse probability propensity score weights using simple regression to account for these two confounders (peripheral tip as central/peripheral and hospitalization as no/yes). Methods: This multicenter, retrospective cohort study was conducted using data from 7 hospitals in Lombardy during the pandemic period from February 21st to May 31st 2020. Results: In the observation period 2206 VADs were evaluated, of which 1107 (50.2%) were inserted in COVID-19 patients. We recorded 42 (1.9%) CRT; 32 (79.2%) were observed in COVID-19 patients. 19 CRBSI were diagnosed. 15 were observed in COVID-19 group (78.95%). Accidental removals were the more represented complication with 123 registered cases, 85 of them (69.1%) were in COVID-19. COVID-19 significantly predicted occurrence of CRT (OR = 2.00(1.85-5.03); P<0.001), CRSB (OR = 3.82(1.82-8.97); P<0.001), and Accidental Removal (OR = 2.39(1.80-3.20); P<0.001) in our propensity score weighted models. Conclusions: CRT, CRBSI, and accidental removal are significantly more frequent in COVID-19 patients, but with a rate similar to the literature reports. Accidental removals are the principal complication, for this reason use of subcutaneously anchored securement is recommended for shorter period than usual.

Vascular findings in CTA body and extremity of critically ill COVID-19 patients: commonly encountered vascular complications with review of literature

“…In a large-scale retrospective study of vascular access in COVID-19 patients, Gidaro et al found catheter-related thrombosis (CRT) occurred in 42 (1.9%) of cases [48]. In other studies, most identified cases occurred in peripheral veins and in the context of hemodialysis [49][50][51][52][53][54]; rare cases of CRT secondary to central venous catheter thrombosis have also been described [55,56].…”