Clinical evolution of patients with lower extremity peripheral artery disease during the COVID-19 pandemic (the COVID-PAD study).
Détails
ID Serval
serval:BIB_08B73304D33E
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Clinical evolution of patients with lower extremity peripheral artery disease during the COVID-19 pandemic (the COVID-PAD study).
Périodique
VASA. Zeitschrift fur Gefasskrankheiten
ISSN
0301-1526 (Print)
ISSN-L
0301-1526
Statut éditorial
Publié
Date de publication
11/2024
Peer-reviewed
Oui
Volume
53
Numéro
6
Pages
378-387
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
<b></b> Background: The COVID-19 pandemic has led to significant disruptions in chronic disease care and forced people to stay at home. The effects of such issues on outpatients with lower extremity peripheral artery disease (PAD) remain unknown. Patients and methods: Single-centre, retrospective-prospective study conducted in a Swiss University Hospital. Patients with PAD were included between May 1 and July 31, 2020, with a follow-up visit at 12 months. Upon both visits, the Leriche-Fontaine PAD stage was recorded, and study participants underwent ankle-brachial index (ABI) calculation to assess limb perfusion. Functional capacities were assessed through the 6-minute walking and treadmill tests. Major adverse cardiovascular (MACE) and limb events (MALE) were recorded. Data collected during the pandemic were compared with the pre-pandemic period (January 1, 2019-April 30, 2020). Results: Overall, 259 patients were included. Mean age was 69 years and male sex was prevalent (69.1%). Odds of experiencing a degradation in PAD stage were lower during the pandemic than before (odds ratio [OR]: 0.43; 95% confidence interval [CI]: 0.21-0.87; p = 0.018). No significant difference was found between periods in terms of ABI trends. Both pain-free walking time at treadmill test (p = 0.003) and maximal pain intensity at 6-minute walking test (p = 0.001) significantly improved during the pandemic. Compared with the pre-pandemic period, during the pandemic patients were hospitalized less frequently (p = 0.028) and were less likely to undergo elective limb revascularization (p<0.001). No significant difference was found between periods in terms of MALE (p = 0.311), whereas non-fatal strokes were less frequently reported during the pandemic (p = 0.043). Conclusion: In a cohort of outpatients with PAD, we found no evidence of clinical deterioration during the pandemic compared with the pre-pandemic period, though rates of adverse events were nonnegligible in both periods. In case of future pandemics, patients with PAD should be encouraged to maintain an active lifestyle while being closely monitored to avoid clinical worsening.
Mots-clé
Humans, COVID-19/epidemiology, Peripheral Arterial Disease/epidemiology, Peripheral Arterial Disease/diagnosis, Peripheral Arterial Disease/physiopathology, Peripheral Arterial Disease/therapy, Male, Aged, Female, Lower Extremity/blood supply, Middle Aged, Retrospective Studies, Prospective Studies, Ankle Brachial Index, Switzerland/epidemiology, SARS-CoV-2, Time Factors, Aged, 80 and over, Risk Factors, Walk Test, Acute limb ischemia, COVID-19 pandemic, amputation, ankle-brachial index, peripheral artery disease, walking performance
Pubmed
Création de la notice
26/07/2024 12:56
Dernière modification de la notice
08/11/2024 18:56