PMID- 35953401
OWN - NLM
STAT- MEDLINE
DCOM- 20221020
LR  - 20221221
IS  - 1876-4738 (Electronic)
IS  - 0914-5087 (Print)
IS  - 0914-5087 (Linking)
VI  - 80
IP  - 6
DP  - 2022 Dec
TI  - Clinical course of patients with chronic limb-threatening ischemia developing 
      COVID-19.
PG  - 545-548
LID - S0914-5087(22)00180-0 [pii]
LID - 10.1016/j.jjcc.2022.07.010 [doi]
AB  - BACKGROUND: The COVID-19 pandemic, caused by severe acute respiratory syndrome 
      coronavirus 2, has overwhelmed healthcare systems. Patients with lower extremity 
      artery disease are at high risk of cardiovascular events, of whom chronic 
      limb-threatening ischemia (CLTI) is the most severe manifestation of peripheral 
      artery disease with an increased risk of mortality compared to patients with 
      intermittent claudication. However, the clinical course of CLTI patients with 
      COVID-19 has not been reported. METHODS: We retrospectively surveyed clinical 
      course for 25 CLTI patients who developed COVID-19 during the "sixth wave" of the 
      pandemic in Japan, which started in January 2022. The primary outcome measure was 
      the 30-day mortality after the diagnosis of COVID-19. We also compared the 
      mortality risk of the 18 COVID-19 patients who underwent initial endovascular 
      treatment with that of 1867 CLTI patients who received initial endovascular 
      treatment before December 2019 (i.e. before the COVID-19 pandemic) (control 
      group). Cox proportional hazard regression model was used to evaluate the effect 
      of COVID-19 on the mortality. To confirm the robustness of these results, we 
      added the analysis with inverse probability weighting (IPW) based on the 
      propensity score for the COVID-19. RESULTS: The 30-day mortality after the 
      diagnosis of COVID-19 reached 20 %; the 95 % confidence interval (CI) of the 
      proportion was calculated to be 7 % to 41 % by the Clopper-Pearson exact method. 
      Cox regression analysis demonstrated the mortality risk was significantly higher 
      in patients developing COVID-19 than in control group [adjusted hazard ratio, 
      3.08 (95 % CI, 1.13-8.37); p = 0.027]. The IPW analysis also confirmed the 
      significant association of COVID-19 with the mortality risk [hazard ratio, 3.97 
      (95 % CI 1.54-10.21, p = 0.004)]. CONCLUSION: In CLTI patients, the 30-day 
      mortality after the diagnosis of COVID-19 reached 20 % (95 % CI, 7 % to 41 %) 
      under the pandemic in January 2022, and patients developing COVID-19 had a 
      significantly higher mortality risk than those treated before the pandemic.
CI  - Copyright (c) 2022 Elsevier Ltd. All rights reserved.
FAU - Ishihara, Takayuki
AU  - Ishihara T
AD  - Kansai Rosai Hospital Cardiovascular Center, Amagasaki, Japan.
FAU - Iida, Osamu
AU  - Iida O
AD  - Kansai Rosai Hospital Cardiovascular Center, Amagasaki, Japan. Electronic 
      address: iida.osa@gmail.com.
FAU - Takahara, Mitsuyoshi
AU  - Takahara M
AD  - Department of Diabetes Care Medicine, Osaka University Graduate School of 
      Medicine, Suita, Japan.
FAU - Tsujimura, Takuya
AU  - Tsujimura T
AD  - Department of Diabetes Care Medicine, Osaka University Graduate School of 
      Medicine, Suita, Japan.
FAU - Higashino, Naoko
AU  - Higashino N
AD  - Kansai Rosai Hospital Cardiovascular Center, Amagasaki, Japan.
FAU - Hata, Yosuke
AU  - Hata Y
AD  - Kansai Rosai Hospital Cardiovascular Center, Amagasaki, Japan.
FAU - Toyoshima, Taku
AU  - Toyoshima T
AD  - Kansai Rosai Hospital Cardiovascular Center, Amagasaki, Japan.
FAU - Nakao, Sho
AU  - Nakao S
AD  - Kansai Rosai Hospital Cardiovascular Center, Amagasaki, Japan.
FAU - Mano, Toshiaki
AU  - Mano T
AD  - Kansai Rosai Hospital Cardiovascular Center, Amagasaki, Japan.
LA  - eng
PT  - Journal Article
DEP - 20220728
PL  - Netherlands
TA  - J Cardiol
JT  - Journal of cardiology
JID - 8804703
SB  - IM
MH  - Humans
MH  - Ischemia/etiology
MH  - *COVID-19/complications
MH  - Retrospective Studies
MH  - *Endovascular Procedures
MH  - Chronic Limb-Threatening Ischemia
MH  - Pandemics
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Time Factors
MH  - *Peripheral Arterial Disease/diagnosis
MH  - Chronic Disease
PMC - PMC9329275
OTO - NOTNLM
OT  - COVID-19
OT  - Chronic limb-threatening ischemia
OT  - Omicron variant
COIS- Declaration of competing interest None to declare.
EDAT- 2022/08/12 06:00
MHDA- 2022/10/21 06:00
PMCR- 2022/07/28
CRDT- 2022/08/11 22:06
PHST- 2022/04/01 00:00 [received]
PHST- 2022/07/02 00:00 [revised]
PHST- 2022/07/06 00:00 [accepted]
PHST- 2022/08/12 06:00 [pubmed]
PHST- 2022/10/21 06:00 [medline]
PHST- 2022/08/11 22:06 [entrez]
PHST- 2022/07/28 00:00 [pmc-release]
AID - S0914-5087(22)00180-0 [pii]
AID - 10.1016/j.jjcc.2022.07.010 [doi]
PST - ppublish
SO  - J Cardiol. 2022 Dec;80(6):545-548. doi: 10.1016/j.jjcc.2022.07.010. Epub 2022 Jul 
      28.