COVID-19 Infection and Early Outcome of Acute Peripheral Vascular Events A propensity Score Matching Analysis

Abstract

AbstractBackground and aim: The present study aimed to compare the short term outcome of thromboembolic events affecting the peripheral vascular system in patients with concomitant COVID-19 infection and patients without this infection. Patients and methods: The study included 177 covid-19 patients with peripheral vascular events. They comprised 62 patients with acute lower limb ischemia, 69 patients with lower limb DVT, 21 patients with thrombosed vascular access and 25 patients with occluded lower limb bypass graft. For comparison, we selected another 177 patients with peripheral vascular events without covid-19 infection. Patients were selected using a propensity score matching with 1:1 ratio. Patients were followed for 30 days after admission. Results: Comparison between acute lower limb ischemia with and without covid-19 revealed that covid-19 patients had higher amputation rate (25.8 % versus 12.9 %, p=0.069) without statistical significance. However, multivariate regression analysis identified covid-19 infection as a significant predictor of limb amputation [OR (95% CI: 3.31 (1.15-9.6), p=0.027]. In DVT patients, covid-19 patients had significantly lower clinical improvement (75.4 % versus 91.3 %, p=0.012). In patients with vascular access thrombosis, covid-19 patients had lower secondary patency rates (61.9 % versus 71.4 %, p=0.52) without statistical significance. In patients with occluded lower limb bypass graft, covid-19 patients had markedly lower secondary patency rates despite falling short of statistical significance (68.0 % versus 88.0 %, p=0.088).Conclusions: Covid-19 infection is related to worse outcome in many patients with peripheral vascular events particularly those with acute lower limb ischemia and DVT.