The global impact of the first Coronavirus Disease 2019 (COVID-19) pandemic wave on vascular services

  1. The VERN COVER study collaborative
  2. Ruth A Benson
  3. Sandip Nandhra

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Abstract

Background

The Coronavirus Disease 2019 (COVID-19) pandemic is having an unprecedented impact on healthcare delivery. This international qualitative study captured the global impact on vascular patient care during the first pandemic ‘wave’.

Methods

An online structured survey was used to collect regular unit-level data regarding the modification to a wide range of vascular services and treatment pathways on a global scale.

Results

The survey commenced on 23 rd March 2020 worldwide. Over six weeks, 249 vascular units took part in 53 countries (465 individual responses). Overall, 65% of units stopped carotid surgery for anyone except patients with crescendo symptoms or offered surgery on a case-by-case basis, 25% only intervened for symptomatic aortic aneurysms cancelling all ‘elective’ repairs. For patients with symptomatic peripheral arterial disease 60% of units moved to an endovascular-first strategy. For patients who had previously undergone endovascular aortic aneurysm repair, 31.8% of units stopped all postoperative surveillance. Of those units regularly engaging in multidisciplinary team meetings, 59.5% of units stopped regular meetings and 39.1% had not replaced them. Further, 20% of units did not have formal personal protective equipment (PPE) guidelines in place and 25% reported insufficient PPE availability.

Conclusions

The COVID-19 pandemic has had a major impact on vascular services worldwide. There will be a significant vascular disease burden awaiting screening and intervention after the pandemic.

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  1. ScreenIT

    SciScore for 10.1101/2020.07.16.20153593: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Study limitations: Despite the large number of units taking part, correlating individual country or regional data with dates of lockdown is challenging. Dates of lockdown were, however, similar for countries providing the majority of responses (UK, Germany, USA). All participating units entered lockdown in March 2020, and were in lockdown when the survey began. As the COVER study continues, we anticipate the widening of practice in the immediate future. If there are any subsequent COVID-19 ‘waves’ in areas that are ‘past the peak’, or in locations where the pandemic peak has yet to occur, this data will support vascular surgeons when deciding on how to adapt practice once again. The impact of cancellations has been modelled for general surgical procedures and predicts a large number of excess deaths16. It will be important for vascular surgery to have similar data available in the same way.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  2. Version published to 10.1101/2020.07.16.20153593v1 on medRxiv