National Cross-Sectional Epidemiological Analysis of the Impact of Pandemic COVID-19 on Vascular Procedures in Public Health System: 521,069 Procedures Over 4 Years

Abstract

During the COVID-19 pandemic, there was a dramatic increase in healthcare demand. Resources were redirected to care patients with COVID-19. Therefore, surgical treatments were affected, including those of vascular diseases. There are no studies evaluating the whole impact of the COVID-19 pandemic, considering all types of vascular procedures, both elective and urgent, in a large country. The aim of the present study was to analyze the impact on all types of vascular procedures performed in Brazilian public hospitals during the COVID-19 pandemic. Cross-sectional population-based analysis of publicly available data referring to vascular procedures. Surgeries two years before the pandemic onset (2018 to 2019) and two years during pandemic (2020 to 2021) were included. We observed a total of 521,069 procedures. Decrease was observed in elective abdominal aortic aneurysm repairs both open surgery (p=0.001) and endovascular surgery (p<0.001), emergency open abdominal AAA repairs (p=0.005), elective thoracic aortic aneurysm repairs (p=0.007), elective open peripheral aneurysm repairs (p=0.038), carotid endarterectomies (p<0.001) and angioplasties (p=0.001), open revascularizations for peripheral arterial disease (p<0.001), surgical treatment of chronic venous disease (p<0.001) and sympathectomies for hyperhidrosis (p<0.001). However, there was a increase of lower limb amputations (p=0.027) and vena cava filter placements (p=0.005). There was a reduction of almost US$17 million in financial investments. The reorganization of health systems led to a significant reduction in vascular procedures and decrease in financial investments. On the other hand, there was a significant increase in the number of lower limb amputations and vena cava filter placements.