Back to Search
Start Over
The Impact of COVID-19 on Vascular Surgery Practice: A Systematic Review.
- Source :
- Vascular & Endovascular Surgery; Aug2021, Vol. 55 Issue 6, p601-611, 11p
- Publication Year :
- 2021
-
Abstract
- Background: COVID-19 is characterized by a pulmonary interstitial compromise which can require intensive care unit (ICU) and mechanical ventilation. Covid patients develop a wide range of pathologies. This study aims to identify the impact of COVID-19 in diseases commonly treated by vascular surgeons. Methods: Four conditions were selected: venous thromboembolism (VTE), pulmonary embolism (PE), peripheral arterial disease (PAD), and microangiopathy. A systematic review of the literature using PRISMA guidelines was. Results: Out of 1195 papers reviewed for conditions in COVID-19 patients relevant to routine vascular surgery practice, 43 papers were included and analyzed. Venous thrombosis was found to be the most common COVID-19 associated pathology with a cumulative incidence of 25% at 7 days and 48% at 14 days. Additionally, D-dimer levels proved to be a good predictor, even in the early stages of the disease with a sensitivity of 85%, specificity of 88.5% and a negative predictive value of 94.7%. Patients in the ICU demonstrated a significantly higher risk of developing VTE, even when receiving pharmacologic thromboprophylaxis. Although evidence of arterial thrombosis was less common (1% to 16.3%), its consequences were typically more serious, including limb loss and death even in young individuals (OR = 25, 95% CI). Finally, microangiopathy has a wide spectrum of clinical presentations from retinal microangiopathy to other more severe manifestations such as myocardial injury, pulmonary compromise and potential multiple organ dysfunction syndrome. Conclusions: Although the pathophysiological pathway by which COVID-19 produces thrombosis is not completely clear, the incidence of both arterial and venous thrombosis is increased. D-dimer screening should be done in all COVID-19 patients, as a predictor of thrombotic complications. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 15385744
- Volume :
- 55
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Vascular & Endovascular Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 151311062
- Full Text :
- https://doi.org/10.1177/1538574421998212