Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

CHOLECOVID Collaborative, (2022) Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study). BJS Open, 6(3), zrac052. (doi: 10.1093/bjsopen/zrac052) (PMID:35511954) (PMCID:PMC9071082)

Abstract

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic.

• Item Type: Articles
• Additional Information: Nigel B. Jamieson is a member of the CHOLECOVID Collaborative.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Jamieson, Professor Nigel
• Authors: CHOLECOVID Collaborative,
• College/School: College of Medical Veterinary and Life Sciences > School of Cancer Sciences
• Journal Name: BJS Open
• Publisher: Oxford University Press
• ISSN: 2474-9842
• ISSN (Online): 2474-9842
• Published Online: 04 May 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in BJS Open 6(3): zrac052
• Publisher Policy: Reproduced under a Creative Commons License

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