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Vasc Med . A cross-sectional study evaluating hospitalization rates for chronic limb-threatening ischemia during the COVID-19 outbreak in Campania,

tetano

Editor, Senior Moderator
Vasc Med


. 2020 Dec 17;1358863X20977678.
doi: 10.1177/1358863X20977678. Online ahead of print.
A cross-sectional study evaluating hospitalization rates for chronic limb-threatening ischemia during the COVID-19 outbreak in Campania, Italy


Eugenio Stabile[SUP] 1 [/SUP], Raffaele Piccolo[SUP] 1 [/SUP], Michele Franzese[SUP] 1 [/SUP], Giancarlo Accarino[SUP] 2 [/SUP], Umberto Marcello Bracale[SUP] 3 [/SUP], Enrico Cappello[SUP] 4 [/SUP], Giovanni Cioffi[SUP] 5 [/SUP], Angelo Cioppa[SUP] 6 [/SUP], Adolfo Crinisio[SUP] 7 [/SUP], Loris Flora[SUP] 8 [/SUP], Pietro Landino[SUP] 9 [/SUP], Eugenio Martelli[SUP] 10 [/SUP], Rosario Mancusi[SUP] 11 [/SUP], Raffaella Niola[SUP] 12 [/SUP], Fernando Petrosino[SUP] 13 [/SUP], Davide Razzano[SUP] 14 [/SUP], Carlo Ruotolo[SUP] 15 [/SUP], Luigi Salemme[SUP] 6 [/SUP], Paolo Sangiuolo[SUP] 16 [/SUP], Gianpaolo Santini[SUP] 17 [/SUP], Emilio Soreca[SUP] 18 [/SUP], Gennaro Vigliotti[SUP] 19 [/SUP], Bruno Villari[SUP] 20 [/SUP], Giampaolo Amabile[SUP] 12 [/SUP], Raffaele Pio Ammollo[SUP] 3 [/SUP], Danilo Barbarisi[SUP] 8 [/SUP], Alfonsina M Corbisiero[SUP] 9 [/SUP], Antonio D'angelo[SUP] 2 [/SUP], Gianluca Cangiano[SUP] 12 [/SUP], Claudia De Gregorio[SUP] 11 [/SUP], Mario De Laurentis[SUP] 16 [/SUP], Eugenio Laurenzano[SUP] 20 [/SUP], Ilaria Ficarelli[SUP] 15 [/SUP], Alessandro Luongo[SUP] 13 [/SUP], Claudio Molino[SUP] 7 [/SUP], Giuseppe Sarti[SUP] 17 [/SUP], Daniela Viola[SUP] 19 [/SUP], Giovanni Esposito[SUP] 1 [/SUP]



Affiliations

Abstract

The expansion of coronavirus disease 2019 (COVID-19) prompted measures of disease containment by the Italian government with a national lockdown on March 9, 2020. The purpose of this study is to evaluate the rate of hospitalization and mode of in-hospital treatment of patients with chronic limb-threatening ischemia (CLTI) before and during lockdown in the Campania region of Italy. The study population includes all patients with CLTI hospitalized in Campania over a 10-week period: 5 weeks before and 5 weeks during lockdown (n = 453). Patients were treated medically and/or underwent urgent revascularization and/or major amputation of the lower extremities. Mean age was 69.2 ? 10.6 years and 27.6% of the patients were women. During hospitalization, 21.9% of patients were treated medically, 78.1% underwent revascularization, and 17.4% required amputations. In the weeks during the lockdown, a reduced rate of hospitalization for CLTI was observed compared with the weeks before lockdown (25 vs 74/100,000 inhabitants/year; incidence rate ratio: 0.34, 95% CI 0.32-0.37). This effect persisted to the end of the study period. An increased amputation rate in the weeks during lockdown was observed (29.3% vs 13.4%; p < 0.001). This study reports a reduced rate of CLTI-related hospitalization and an increased in-hospital amputation rate during lockdown in Campania. Ensuring appropriate treatment for patients with CLTI should be prioritized, even during disease containment measures due to the COVID-19 pandemic or other similar conditions.

Keywords: COVID-19; chronic limb-threatening ischemia (CLTI); peripheral artery disease (PAD).
 
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