Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)
Author:
, Spiers Harry V M, Kouli Omar, Ahmed Waheed U, Varley Rebecca, Ahari Daniel, Argus Leah, McLean Kenneth A, Kamarajah Sivesh K, Coe Peter, Griffiths Ewen A, Chan Anthony KC, Macutkiewicz Christian, Jamdar Saurabh, Wilson Michael, Fullwood Catherine, Toogood Giles, Siriwardena Ajith KORCID, Kouli Omar, McLean Kenneth, Fullwood Catherine, Ahari Daniel, Argus Leah, Varley Rebecca, Spiers Harry V M, Kouli Omar, Ahmed Waheed, Gilchrist Andrew, Goldsworthy Matthew, Rashid Majid, Pockney P, Varela J, Brindl N, Ramirez J, Marafante C, Iwao Y, Ghzawi A, Elhadi M, Gacaferi H, Varghese C, Adeyeye A, Alser O, Teh C, Prieto M, Hasan A, Al-Naggar H, Salgado R, Veracierto F, Lancelotti T, Solinas D, Oddi R, Garcia FW, Mazza Diez E, Andrade Ramirez MR, Bracco R, Fernandez D, Maraschio MA, Obeide L, Giordano E, Alcaraz A, Marani MA, Aguirre N, Luna F, Francesconi M, Chiham F, Ramos Cossio R, Alvarez FA, Pantoja Pachajoa DA, Mandojana F, Merlo IG, Gonzalez MH, Cervelo G, Puma R, Vardaro GF, Davis A, Jurat D, Guenoff C, Raubenheimer K, Goddard K, Brown K, Wegrecki KJ, Cheung HYC, Yang M, Cheung H, Siddiqui J, Ahn JH, Huynh R, Lam YH, Afzal M, Ong BS, Chua MYM, Ly K, Thomson JE, Watson D, Dawson AC, Drane A, Van Ruyven S, Lun EWY, Pockney P, Ferguson M, Jeong JY, De Silva C, Wills V, Gundara J, Mccourt E, Bong C, Tabone R, Wong WJ, Gray A, Koh D, Pollock M, Singhal S, Smith R, Dudi-Venkata NN, Kanhere H, Stranz C, Seow W, Mansour LT, Wormald J, Loveday BPT, Thomson B, O’Donnell T, Milenkovski N, Herath M, Trochsler M, Farfus A, Maddern G, Bunjo Z, Kuan LL, Atanasov G, Dawson A, Drane A, van Ruyven S, Lun E, Samadov E, Namazov I, Asgarov M, Ibrahimli A, Srinivasan M, Saeed MF, Aljawder H, Juma I, Coimbra FJ, Marques N, Casteleins WA, Petruzziello A, Jabur G, Rodriguez JFP, Buso PL, MacKenzie S, Hsiao M, Sljivic I, Tecson A, Karanicolas PJ, Roke R, Moon J, Butler EV, Riquelme F, Yanez M, Catan F, Uribe M, Carriel F, Oppliger F, Paredes A, Daroch D, Aguayo JC, Perez Rivera CJ, Acosta Buitrago LM, Kadamani Abiyomaa A, Mosquera Paz MS, Cabrera P, Corso J, Ozcay N, Ozant A, Arslan K, Besim H, Almezghwi H, Azzam AY, Bessa S, El-Sayes I, Badawy A, Wael M, El-Gendi A, Azab MA, Fayed M, El Kassas M, Gamal M, Tawheed A, Al Shafie A, Emile S, Elfallal A, Elfeki H, Shalaby M, Sakr A, Elbahnasawy M, Shama M, Abdel-Elsalam W, Abd-Elsalam S, Escobar Dominguez JE, Medrano F, Gaitan S, Escalon Gonzalez OM, Alfaro Varela JC, Cea M, Interiano M, Cabrera B, Lakkis Z, Georges P, Antonot C, Magnin J, Kamphues C, Lauscher JC, Schineis C, Loch FN, Lee LD, Beyer K, Bouchagier K, Galanis I, Bartziotas D, Lostoridis E, Tourountzi P, Nagorni EA, Charalabopoulos A, Baili E, Kyros E, Vagios I, Skotsimara A, Liakakos T, Alexandrou A, Papalampros A, Papadopolous V, Tooulias A, Kentarchos I, Christou C, Tsoulfas G, Tale-Rosales LF, Lopez Muralles I, Melendez H, Bran G, Monroy Mahecha FA, Contreras JR, Porras DE, Paiz E, Soto ER, Ixcayau Hernandez JR, Gupta A, Rajput D, Kumar N, Mani R, Kant R, 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Aldowbli S, Al-Shehari M, Shream S, Al-Ameri S, Aeed M, Al-Naggar H, Aldawbali M, Alsayadi R, Alsayadi M
Abstract
Abstract
Background
This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic.
Methods
CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality.
Results
This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121).
Conclusion
CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic.
Publisher
Oxford University Press (OUP)
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