The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis?
- Authors: De Simone B.; Abu-Zidan F.M.; Chouillard E.; Di Saverio S.; Sartelli M.; Podda M.; Gomes C.A.; Moore E.E.; Moug S.J.; Ansaloni L.; Kluger Y.; Coccolini F.; Landaluce-Olavarria A.; Estraviz-Mateos B.; Uriguen-Etxeberria A.; Giordano A.; Luna A.P.; Amin L.A.H.; Hernandez A.M.P.; Shabana A.; Dzulkarnaen Z.A.; Othman M.A.; Sani M.I.; Balla A.; Scaramuzzo R.; Lepiane P.; Bottari A.; Staderini F.; Cianchi F.; Cavallaro A.; Zanghi A.; Cappellani A.; Campagnacci R.; Maurizi A.; Martinotti M.; Ruggieri A.; Jusoh A.C.; Rahman K.A.; Zulkifli A.S.M.; Petronio B.; Matias-Garcia B.; Quiroga-Valcarcel A.; Mendoza-Moreno F.; Atanasov B.; Campanile F.C.; Vecchioni I.; Cardinali L.; Travaglini G.; Sebastiani E.; Chooklin S.; Chuklin S.; Cianci P.; Restini E.; Capuzzolo S.; Curro G.; Filippo R.; Rispoli M.; Aparicio-Sanchez D.; Munoz-Cruzado V.D.; Barbeito S.D.; Delibegovic S.; Kesetovic A.; Sasia D.; Borghi F.; Giraudo G.; Visconti D.; Doria E.; Santarelli M.; Luppi D.; Bonilauri S.; Grossi U.; Zanus G.; Sartori A.; Piatto G.; De Luca M.; Vita D.; Conti L.; Capelli P.; Cattaneo G.M.; Marinis A.; Vederaki S.-A.; Bayrak M.; Altintas Y.; Uzunoglu M.Y.; Demirbas I.E.; Altinel Y.; Meric S.; Aktimur Y.E.; Uymaz D.S.; Omarov N.; Azamat I.; Lostoridis E.; Nagorni E.-A.; Pujante A.; Anania G.; Bombardini C.; Bagolini F.; Gonullu E.; Mantoglu B.; Capoglu R.; Cappato S.; Muzio E.; Colak E.; Polat S.; Koylu Z.A.; Altintoprak F.; Bayhan Z.; Akin E.; Andolfi E.; Rezart S.; Kim J.I.; Jung S.W.; Shin Y.C.; Enciu O.; Toma E.A.; Medas F.; Canu G.L.; Cappellacci F.; D'Acapito F.; Ercolani G.; Solaini L.; Roscio F.; Clerici F.; Gelmini R.; Serra F.; Rossi E.G.; Fleres F.; Clarizia G.; Spolini A.; Ferrara F.; Nita G.; Sarnari J.; Gachabayov M.; Abdullaev A.; Poillucci G.; Palini G.M.; Veneroni S.; Garulli G.; Piccoli M.; Pattacini G.C.; Pecchini F.; Argenio G.; Armellino M.F.; Brisinda G.; Tedesco S.; Fransvea P.; Ietto G.; Franchi C.; Carcano G.; Martines G.; Trigiante G.; Negro G.; Vega G.M.; Gonzalez A.R.; Ojeda L.; Piccolo G.; Bondurri A.; Maffioli A.; Guerci C.; Sin B.H.; Zuhdi Z.; Azman A.; Mousa H.; al Bahri S.; Augustin G.; Romic I.; Moric T.; Nikolopoulos I.; Andreuccetti J.; Pignata G.; D'Alessio R.; Kenig J.; Skorus U.; Fraga G.P.; Hirano E.S.; de Lima Bertuol J.V.; Isik A.; Kurnaz E.; Asghar M.S.; Afzal A.; Akbar A.; Nikolouzakis T.K.; Lasithiotakis K.; Chrysos E.; Das K.; Ozer N.; Seker A.; Ibrahim M.; Hamid H.K.S.; Babiker A.; Bouliaris K.; Koukoulis G.; Kolla C.-C.; Lucchi A.; Agostinelli L.; Taddei A.; Fortuna L.; Agostini C.; Licari L.; Viola S.; Callari C.; Laface L.; Abate E.; Casati M.; Anastasi A.; Canonico G.; Gabellini L.; Tosi L.; Guariniello A.; Zanzi F.; Bains L.; Sydorchuk L.; Iftoda O.; Sydorchuk A.; Malerba M.; Costanzo F.; Galleano R.; Monteleone M.; Costanzi A.; Riva C.; Waledziak M.; Kwiatkowski A.; Czyzykowski L.; Major P.; Strzalka M.; Matyja M.; Natkaniec M.; Valenti M.R.; Di Vita M.D.P.; Sotiropoulou M.; Kapiris S.; Massalou D.; Veroux M.; Volpicelli A.; Gioco R.; Uccelli M.; Bonaldi M.; Olmi S.; Nardi M.; Livadoti G.; Mesina C.; Dumitrescu T.V.; Ciorbagiu M.C.; Ammendola M.; Ammerata G.; Romano R.; Slavchev M.; Misiakos E.P.; Pikoulis E.; Papaconstantinou D.; Elbahnasawy M.; Abdel-elsalam S.; Felsenreich D.M.; Jedamzik J.; Michalopoulos N.V.; Sidiropoulos T.A.; Papadoliopoulou M.; Cillara N.; Deserra A.; Cannavera A.; Negoi I.; Schizas D.; Syllaios A.; Vagios I.; Gourgiotis S.; Dai N.; Gurung R.; Norrey M.; Pesce A.; Feo C.V.; Fabbri N.; Machairas N.; Dorovinis P.; Keramida M.D.; Mulita F.; Verras G.I.; Vailas M.; Yalkin O.; Iflazoglu N.; Yigit D.; Baraket O.; Ayed K.; Ghalloussi M.; Patias P.; Ntokos G.; Rahim R.; Bala M.; Kedar A.; Sawyer R.G.; Trinh A.; Miller K.; Sydorchuk R.; Knut R.; Plehutsa O.; Liman R.K.; Ozkan Z.; Kader S.A.; Gupta S.; Gureh M.; Saeidi S.; Aliakbarian M.; Dalili A.; Shoko T.; Kojima M.; Nakamoto R.; Atici S.D.; Tuncer G.K.; Kaya T.; Delis S.G.; Rossi S.; Picardi B.; del Monte S.R.; Triantafyllou T.; Th
- Publication year: 2022
- Type: Articolo in rivista
- OA Link: http://hdl.handle.net/10447/613433
Abstract
Background: The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not. Methods: Data were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not. Results: A total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were negative. Concomitant preexisting diseases including cardiovascular diseases (p < 0.0001), diabetes (p < 0.0001), and severe chronic obstructive airway disease (p = 0.005) were significantly more frequent in the COVID-19 group. Markers of sepsis severity including ARDS (p < 0.0001), PIPAS score (p < 0.0001), WSES sepsis score (p < 0.0001), qSOFA (p < 0.0001), and Tokyo classification of severity of acute cholecystitis (p < 0.0001) were significantly higher in the COVID-19 group. The COVID-19 group had significantly higher postoperative complications (32.2% compared with 11.7%, p < 0.0001), longer mean hospital stay (13.21 compared with 6.51 days, p < 0.0001), and mortality rate (13.4% compared with 1.7%, p < 0.0001). The incidence of gangrenous cholecystitis was doubled in the COVID-19 group (40.7% compared with 22.3%). The mean wall thickness of the gallbladder was significantly higher in the COVID-19 group [6.32 (SD: 2.44) mm compared with 5.4 (SD: 3.45) mm; p < 0.0001]. Conclusions: The incidence of gangrenous cholecystitis is higher in COVID patients compared with non-COVID patients admitted to the emergency department with acute cholecystitis. Gangrenous cholecystitis in COVID patients is associated with high-grade Clavien-Dindo postoperative complications, longer hospital stay and higher mortality rate. The open cholecystectomy rate is higher in COVID compared with non -COVID patients. It is recommended to delay the surgical treatment in COVID patients, when it is possible, to decrease morbidity and mortality rates. COVID-19 infection and gangrenous cholecystistis are not absolute contraindications to perform laparoscopic cholecystectomy, in a case by case evaluation, in expert hands. Graphical abstract: [Figure not available: see fulltext.]