Dataset Information

The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis?

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.

SUBMITTER: De Simone B

PROVIDER: S-EPMC9755784 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis?

De Simone Belinda B Abu-Zidan Fikri M FM Chouillard Elie E Di Saverio Salomone S Sartelli Massimo M Podda Mauro M Gomes Carlos Augusto CA Moore Ernest E EE Moug Susan J SJ Ansaloni Luca L Kluger Yoram Y Coccolini Federico F Landaluce-Olavarria Aitor A Estraviz-Mateos Begoña B Uriguen-Etxeberria Ana A Giordano Alessio A Luna Alfonso Palmieri AP Amín Luz Adriana Hernández LAH Hernández Adriana María Palmieri AMP Shabana Amanda A Dzulkarnaen Zakaria Andee ZA Othman Muhammad Asyraf MA Sani Mohamad Ikhwan MI Balla Andrea A Scaramuzzo Rosa R Lepiane Pasquale P Bottari Andrea A Staderini Fabio F Cianchi Fabio F Cavallaro Andrea A Zanghì Antonio A Cappellani Alessandro A Campagnacci Roberto R Maurizi Angela A Martinotti Mario M Ruggieri Annamaria A Jusoh Asri Che AC Rahman Karim Abdul KA Zulkifli Anis Suraya M ASM Petronio Barbara B Matías-García Belén B Quiroga-Valcárcel Ana A Mendoza-Moreno Fernando F Atanasov Boyko B Campanile Fabio Cesare FC Vecchioni Ilaria I Cardinali Luca L Travaglini Grazia G Sebastiani Elisa E Chooklin Serge S Chuklin Serhii S Cianci Pasquale P Restini Enrico E Capuzzolo Sabino S Currò Giuseppe G Filippo Rosalinda R Rispoli Michele M Aparicio-Sánchez Daniel D Muñóz-Cruzado Virginia Durán VD Barbeito Sandra Dios SD Delibegovic Samir S Kesetovic Amar A Sasia Diego D Borghi Felice F Giraudo Giorgio G Visconti Diego D Doria Emanuele E Santarelli Mauro M Luppi Davide D Bonilauri Stefano S Grossi Ugo U Zanus Giacomo G Sartori Alberto A Piatto Giacomo G De Luca Maurizio M Vita Domenico D Conti Luigi L Capelli Patrizio P Cattaneo Gaetano Maria GM Marinis Athanasios A Vederaki Styliani-Aikaterini SA Bayrak Mehmet M Altıntas Yasemin Y Uzunoglu Mustafa Yener MY Demirbas Iskender Eren IE Altinel Yuksel Y Meric Serhat S Aktimur Yunus Emre YE Uymaz Derya Salim DS Omarov Nail N Azamat Ibrahim I Lostoridis Eftychios E Nagorni Eleni-Aikaterini EA Pujante Antonio A Anania Gabriele G Bombardini Cristina C Bagolini Francesco F Gonullu Emre E Mantoglu Baris B Capoglu Recayi R Cappato Stefano S Muzio Elena E Colak Elif E Polat Suleyman S Koylu Zehra Alan ZA Altintoprak Fatih F Bayhan Zülfü Z Akin Emrah E Andolfi Enrico E Rezart Sulce S Kim Jae Il JI Jung Sung Won SW Shin Yong Chan YC Enciu Octavian O Toma Elena Adelina EA Medas Fabio F Canu Gian Luigi GL Cappellacci Federico F D'Acapito Fabrizio F Ercolani Giorgio G Solaini Leonardo L Roscio Francesco F Clerici Federico F Gelmini Roberta R Serra Francesco F Rossi Elena Giulia EG Fleres Francesco F Clarizia Guglielmo G Spolini Alessandro A Ferrara Francesco F Ferrara Francesco F Nita Gabriela G Sarnari Jlenia J Gachabayov Mahir M Abdullaev Abakar A Poillucci Gaetano G Palini Gian Marco GM Veneroni Simone S Garulli Gianluca G Piccoli Micaela M Pattacini Gianmaria Casoni GC Pecchini Francesca F Argenio Giulio G Armellino Mariano Fortunato MF Brisinda Giuseppe G Tedesco Silvia S Fransvea Pietro P Ietto Giuseppe G Franchi Caterina C Carcano Giulio G Martines Gennaro G Trigiante Giuseppe G Negro Giulia G Vega Gustavo Machain GM González Agustín Rodríguez AR Ojeda Leonardo L Piccolo Gaetano G Bondurri Andrea A Maffioli Anna A Guerci Claudio C Sin Boo Han BH Zuhdi Zamri Z Azman Azlanudin A Mousa Hussam H Al Bahri Shadi S Augustin Goran G Romic Ivan I Moric Trpimir T Nikolopoulos Ioannis I Andreuccetti Jacopo J Pignata Giusto G D'Alessio Rossella R Kenig Jakub J Skorus Urszula U Fraga Gustavo Pereira GP Hirano Elcio Shiyoiti ES de Lima Bertuol Jackson Vinícius JV Isik Arda A Kurnaz Eray E Asghar Mohammad Sohail MS Afzal Ameer A Akbar Ali A Nikolouzakis Taxiarchis Konstantinos TK Lasithiotakis Konstantinos K Chrysos Emmanuel E Das Koray K Özer Nazmi N Seker Ahmet A Ibrahim Mohamed M Hamid Hytham K S HKS Babiker Ahmed A Bouliaris Konstantinos K Koukoulis George G Kolla Chrysoula-Christina CC Lucchi Andrea A Agostinelli Laura L Taddei Antonio A Fortuna Laura L Agostini Carlotta C Licari Leo L Viola Simona S Callari Cosimo C Laface Letizia L Abate Emmanuele E Casati Massimiliano M Anastasi Alessandro A Canonico Giuseppe G Gabellini Linda L Tosi Lorenzo L Guariniello Anna A Zanzi Federico F Bains Lovenish L Sydorchuk Larysa L Iftoda Oksana O Sydorchuk Andrii A Malerba Michele M Costanzo Federico F Galleano Raffaele R Monteleone Michela M Costanzi Andrea A Riva Carlo C Walędziak Maciej M Kwiatkowski Andrzej A Czyżykowski Łukasz Ł Major Piotr P Strzałka Marcin M Matyja Maciej M Natkaniec Michal M Valenti Maria Rosaria MR Di Vita Maria Domenica Pia MDP Sotiropoulou Maria M Kapiris Stylianos S Massalou Damien D Veroux Massimiliano M Volpicelli Alessio A Gioco Rossella R Uccelli Matteo M Bonaldi Marta M Olmi Stefano S Nardi Matteo M Livadoti Giada G Mesina Cristian C Dumitrescu Theodor Viorel TV Ciorbagiu Mihai Calin MC Ammendola Michele M Ammerata Giorgio G Romano Roberto R Slavchev Mihail M Misiakos Evangelos P EP Pikoulis Emmanouil E Papaconstantinou Dimitrios D Elbahnasawy Mohamed M Abdel-Elsalam Sherief S Felsenreich Daniel M DM Jedamzik Julia J Michalopoulos Nikolaos V NV Sidiropoulos Theodoros A TA Papadoliopoulou Maria M Cillara Nicola N Deserra Antonello A Cannavera Alessandro A Negoi Ionuţ I Schizas Dimitrios D Syllaios Athanasios A Vagios Ilias I Gourgiotis Stavros S Dai Nick N Gurung Rekha R Norrey Marcus M Pesce Antonio A Feo Carlo Vittorio CV Fabbri Nicolo' N Machairas Nikolaos N Dorovinis Panagiotis P Keramida Myrto D MD Mulita Francesk F Verras Georgios Ioannis GI Vailas Michail M Yalkin Omer O Iflazoglu Nidal N Yigit Direnc D Baraket Oussama O Ayed Karim K Ghalloussi Mohamed Hedi MH Patias Parmenion P Ntokos Georgios G Rahim Razrim R Bala Miklosh M Kedar Asaf A Sawyer Robert G RG Trinh Anna A Miller Kelsey K Sydorchuk Ruslan R Knut Ruslan R Plehutsa Oleksandr O Liman Rumeysa Kevser RK Ozkan Zeynep Z Kader Saleh Abdel SA Gupta Sanjay S Gureh Monika M Saeidi Sara S Aliakbarian Mohsen M Dalili Amin A Shoko Tomohisa T Kojima Mitsuaki M Nakamoto Raira R Atici Semra Demirli SD Tuncer Gizem Kilinc GK Kaya Tayfun T Delis Spiros G SG Rossi Stefano S Picardi Biagio B Del Monte Simone Rossi SR Triantafyllou Tania T Theodorou Dimitrios D Pintar Tadeja T Salobir Jure J Manatakis Dimitrios K DK Tasis Nikolaos N Acheimastos Vasileios V Ioannidis Orestis O Loutzidou Lydia L Symeonidis Savvas S de Sá Tiago Correia TC Rocha Mónica M Guagni Tommaso T Pantalone Desiré D Maltinti Gherardo G Khokha Vladimir V Abdel-Elsalam Wafaa W Ghoneim Basma B López-Ruiz José Antonio JA Kara Yasin Y Zainudin Syaza S Hayati Firdaus F Azizan Nornazirah N Khei Victoria Tan Phooi VTP Yi Rebecca Choy Xin RCX Sellappan Harivinthan H Demetrashvili Zaza Z Lekiashvili Nika N Tvaladze Ana A Froiio Caterina C Bernardi Daniele D Bonavina Luigi L Gil-Olarte Angeles A Grassia Sebastiano S Romero-Vargas Estela E Bianco Francesco F Gumbs Andrew A AA Dogjani Agron A Agresta Ferdinando F Litvin Andrey A Balogh Zsolt J ZJ Gendrikson George G Martino Costanza C Damaskos Dimitrios D Pararas Nikolaos N Kirkpatrick Andrew A Kurtenkov Mikhail M Gomes Felipe Couto FC Pisanu Adolfo A Nardello Oreste O Gambarini Fabrizio F Aref Hager H Angelis Nicola De' ND Agnoletti Vanni V Biondi Antonio A Vacante Marco M Griggio Giulia G Tutino Roberta R Massani Marco M Bisetto Giovanni G Occhionorelli Savino S Andreotti Dario D Lacavalla Domenico D Biffl Walter L WL Catena Fausto F

World journal of emergency surgery : WJES 20221216 1

<h4>Background</h4>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.<h4>Methods</h4>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 isolate ...[more]

PMID: 36527038

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Project description:AimTo compare deep learning and experienced physicians in diagnosing gangrenous cholecystitis using computed tomography images and explore the feasibility of diagnostic assistance for acute cholecystitis requiring emergency surgery.MethodsThis retrospective study included 25 patients with pathologically confirmed gangrenous cholecystitis and 129 patients with noncomplicated acute cholecystitis who underwent computed tomography between 2016 and 2021 at two institutions. All available computed tomography images at the time of the initial diagnosis were used for the analysis. A deep learning model based on a convolutional neural network was trained using 1,517 images of 112 patients (18 patients with gangrenous cholecystitis and 94 patients with acute cholecystitis) and tested with 68 images of 42 patients (seven patients with gangrenous cholecystitis and 35 patients with acute cholecystitis). Three blinded, experienced physicians independently interpreted the test images. The sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve were compared between the convolutional neural network and the reviewers.ResultsThe convolutional neural network (sensitivity, 0.70; 95% confidence interval [CI], 0.44-0.87, specificity, 0.93; 95% CI, 0.88-0.96, accuracy, 0.89; 95% CI, 0.81-0.95, area under the receiver operating characteristic curve, 0.84; 95% CI, 0.68-1.00) had achieved a better diagnostic performance than the reviewers (ex. sensitivity, 0.55; 95% CI, 0.30-0.77, specificity, 0.67; 95% CI, 0.62-0.71, accuracy, 0.65; 95% CI, 0.57-0.72, area under the receiver operating characteristic curve, 0.63; 95% CI, 0.44-0.82; P = 0.048 for area under the receiver operating characteristic curve versus convolutional neural network).ConclusionsDeep learning had a better diagnostic performance than experienced reviewers in diagnosing gangrenous cholecystitis and has potential applicability for assisting in identifying indications for emergency surgery in the future.

Project description:BackgroundThis study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic.MethodsCHOLECOVID 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.ResultsThis 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).ConclusionCHOLECOVID 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.

Project description:AimsA novel coronavirus SARS-CoV-2 has resulted in an ongoing global pandemic of Coronavirus disease 2019 (COVID-19). However, the outcomes of recovered patients have not been well defined.MethodsThis is a prospective observational follow-up study of survivors with COVID-19 from a designated tertiary center in Hefei, China. We examined chest computed tomography (CT) scanning, pulmonary function, 6-min walk distance (6MWD), and 36 item Short Form General Health Survey (SF-36).ResultsAmong 81 enrolled patients, 62 (77%) patients and 61 (75%) patients, respectively, completed 1-month and 3-month follow-ups. Abnormal CT findings were still present in 73% of patients at 1 month and 54% at 3 months, whereas chest CT scan scores improved progressively at 1-month (5.0 ± 5.1) and 3-month follow up (3.0 ± 4.5) compared with that during hospitalization (11 ± 6.8). Mild restrictive pulmonary impairment was detected in 11% and 10% of patients at 1-month and 3-month follow up, respectively. The 6MWD was 523 ± 77 m in male patients and 484 ± 58 m in female patients, which was significantly lower than in healthy controls (606 ± 68 m, 568 ± 78 m, p < 0.001). SF-36 scores were significantly impaired in the domains of role physical (RP), role emotional (RE), and social functioning (SF) compared with the normal age-matched population. RP was improved at 3-month compared with 1-month follow up in the 41-64 years group (p < 0.01). Multivariable analysis showed that older age (over 40 years) and steroid administration during hospitalization were independently associated with worse chest CT scores at 3-month follow up.ConclusionsAt 3 months, chest CT abnormalities were present in one half of COVID-19 survivors and worse chest CT scores were independently associated with older age and steroid administration during hospitalization. Residual pulmonary function impairments were modest, whereas exercise capacity and SF-36 scores were significantly lower than the general population. Support program and further follow-up evaluations may be needed.The reviews of this paper are available via the supplemental material section.

Dataset Information

The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis?

Background

Methods

Results

Conclusions

Publications

The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis?

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