COVID-19 infection is a significant risk factor for death in patients presenting with acute cholecystitis: a secondary analysis of the ChoCO-W cohort study

De Simone, B.; Abu-Zidan, F. M.; Kasongo, L.; Moore, E. E.; Podda, M.; Sartelli, M.; Isik, A.; Bala, M.; Coimbra, R.; Balogh, Z. J.; Rasa, K.; Marchegiani, F.; Schena, C. A.; Deangelis, N.; Di Martino, M.; Ansaloni, L.; Coccolini, F.; Gumbs, A. A.; Biffl, W. L.; Pikoulis, E.; Pararas, N.; Chouillard, E.; Garulli, G.; Lacavalla, D.; Andreotti, D.; Occhionorelli, S.; Bisetto, G.; Massani, M.; Tutino, R.; Griggio, G.; Vacante, M.; Biondi, A.; Agnoletti, V.; Gambarini, F.; Nardello, O.; Pisanu, A.; Gomes, F. C.; Kurtenkov, M.; Kirkpatrick, A.; Damaskos, D.; Martino, C.; Gendrikson, G.; Dogjani, A.; Bianco, F.; Romero-Vargas, E.; Grassia, S.; Gil-Olarte, A.; Bonavina, L.; Bernardi, D.; Froiio, C.; Tvaladze, A.; Lekiashvili, N.; Demetrashvili, Z.; Sellappan, H.; R. C. X., Yi; Khei, V. T. P.; Azizan, N.; Hayati, F.; Zainudin, S.; Kara, Y.; Lopez-Ruiz, J. A.; Ghoneim, B.; Abdel-Elsalam, W.; Khokha, V.; Maltinti, G.; Pantalone, D.; Guagni, T.; Rocha, M.; De Sa, T. C.; Symeonidis, S.; Loutzidou, L.; Ioannidis, O.; Acheimastos, V.; Tasis, N.; Manatakis, D. K.; Salobir, J.; Pintar, T.; Theodorou, D.; Triantafyllou, T.; Del Monte, S. R.; Picardi, B.; Rossi, S.; Delis, S. G.; Kaya, T.; Tuncer, G. K.; Atici, S. D.; Nakamoto, R.; Kojima, M.; Shoko, T.; Dalili, A.; Aliakbarian, M.; Saeidi, S.; Gureh, M.; Gupta, S.; Kader, S. A.; Ozkan, Z.; Liman, R. K.; Plehutsa, O.; Knut, R.; Sydorchuk, R.; Miller, K.; Trinh, A.; Sawyer, R. G.; Kedar, A.; Rahim, R.; Ntokos, G.; Patias, P.; Ghalloussi, M. H.; Ayed, K.; Baraket, O.; Yigit, D.; Iflazoglu, N.; Yalkin, O.; Vailas, M.; Verras, G. I.; Mulita, F.; Keramida, M. D.; Dorovinis, P.; Machairas, N.; Fabbri, N.; Feo, C. V.; Pesce, A.; Norrey, M.; Gurung, R.; Dai, N.; Gourgiotis, S.; Vagios, I.; Syllaios, A.; Schizas, D.; Negoi, I.; Cannavera, A.; Deserra, A.; Cillara, N.; Papadoliopoulou, M.; Sidiropoulos, T. A.; Michalopoulos, N. V.; Jedamzik, J.; Felsenreich, D. M.; Abdel-Elsalam, S.; Elbahnasawy, M.; Papaconstantinou, D.; Misiakos, E. P.; Slavchev, M.; Romano, R.; Ammerata, G.; Ammendola, M.; Ciorbagiu, M. C.; Dumitrescu, T. V.; Mesina, C.; Livadoti, G.; Nardi, M.; Olmi, S.; Bonaldi, M.; Uccelli, M.; Gioco, R.; Volpicelli, A.; Veroux, M.; Massalou, D.; Kapiris, S.; Sotiropoulou, M.; Di Vita, M. D. P.; Valenti, M. R.; Natkaniec, M.; Matyja, M.; Strzalka, M.; Major, P.; Czyzykowski, L.; Kwiatkowski, A.; Waledziak, M.; Riva, C.; Costanzi, A.; Monteleone, M.; Galleano, R.; Costanzo, F.; Malerba, M.; Sydorchuk, A.; Iftoda, O.; Sydorchuk, L.; Bains, L.; Zanzi, F.; Guariniello, A.; Tosi, L.; Gabellini, L.; Canonico, G.; Anastasi, A.; Casati, M.; Abate, E.; Laface, L.; Callari, C.; Viola, S.; Licari, L.; Agostini, C.; Fortuna, L.; Taddei, A.; Agostinelli, L.; Lucchi, A.; Kolla, C. -C.; Koukoulis, G.; Bouliaris, K.; Babiker, A.; Hamid, H. K. S.; Ibrahim, M.; Seker, A.; Ozer, N.; Das, K.; Chrysos, E.; Lasithiotakis, K.; Nikolouzakis, T. K.; Akbar, A.; Afzal, A.; Asghar, M. S.; Kurnaz, E.; De Lima Bertuol, J. V.; Hirano, E. S.; Fraga, G. P.; Skorus, U.; Kenig, J.; D'Alessio, R.; Pignata, G.; Andreuccetti, J.; Nikolopoulos, I.; Moric, T.; Romic, I.; Augustin, G.; Al Bahri, S.; Mousa, H.; Azman, A.; Zuhdi, Z.; Sin, B. H.; Guerci, C.; Maffioli, A.; Bondurri, A.; Piccolo, G.; Ojeda, L.; Gonzalez, A. R.; Vega, G. M.; Negro, G.; Trigiante, G.; Martines, G.; Carcano, G.; Franchi, C.; Ietto, G.; Fransvea, P.; Tedesco, S.; Brisinda, G.; Armellino, M. F.; Argenio, G.; Pecchini, F.; Pattacini, G. C.; Piccoli, M.; Veneroni, L.; Palini, G. M.; Poillucci, G.; Abdullaev, A.; Gachabayov, M.; Sarnari, J.; Nita, G.; Ferrara, F.; Spolini, A.; Clarizia, G.; Fleres, F.; Rossi, E. G.; Serra, F.; Gelmini, R.; Clerici, F.; Roscio, F.; Solaini, L.; Ercolani, G.; D'Acapito, F.; Cappellacci, F.; Canu, G. L.; Medas, F.; Toma, E. A.; Enciu, O.; Shin, Y. C.; Jung, S. W.; Kim, J. I.; Rezart, S.; Andolfi, E.; Bayhan, Z.; Altintoprak, F.; Koylu, Z. A.; Polat, S.; Colak, E.; Muzio, E.; Cappato, S.; Capoglu, R.; Mantoglu, B.; Gonullu, E.; Bagolini, F.; Bombardini, C.; Anania, G.; Pujante, A.; Nagorni, E. -A.; Lostoridis, E.; Azamat, I.; Omarov, N.; Uymaz, D. S.; Aktimur, Y. E.; Meric, S.; Altinel, Y.; Demirbas, I. E.; Uzunoglu, M. Y.; Altintas, Y.; Bayrak, M.; Vederaki, S. -A.; Marinis, A.; Cattaneo, G. M.; Capelli, P.; Conti, L.; Vita, D.; De Luca, M.; Piatto, G.; Sartori, A.; Zanus, G.; Grossi, U.; Bonilauri, S.; Luppi, D.; Santarelli, M.; Doria, E.; Visconti, D.; Giraudo, G.; Borghi, F.; Sasia, D.; Kesetovic, A.; Delibegovic, S.; Barbeito, S. D.; Munoz-Cruzado, V. D.; Aparicio-Sanchez, D.; Rispoli, M.; Filippo, R.; Curro, G.; Capuzzolo, S.; Restini, E.; Cianci, P.; Chuklin, S.; Chooklin, S.; Sebastiani, E.; Travaglini, G.; Cardinali, L.; Vecchioni, I.; Campanile, F. C.; Atanasov, B.; Mendoza-Moreno, F.; Quiroga-Valcarcel, A.; Matias-Garcia, B.; Petronio, B.; Zulkifli, A. S. M.; Rahman, K. A.; Jusoh, A. C.; Ruggieri, A.; Martinotti, M.; Maurizi, A.; Campagnacci, R.; Cappellani, A.; Zanghi, A.; Cavallaro, A.; Cianchi, F.; Staderini, F.; Bottari, A.; Lepiane, P.; Scaramuzzo, R.; Balla, A.; Sani, M. I.; Othman, M. A.; Dzulkarnaen, Z. A.; Shabana, A.; Hernandez, A. M. P.; Amin, L. A. H.; Luna, A. P.; Giordano, A.; Uriguen-Etxeberria, A.; Estraviz-Mateos, B.; Landaluce-Olavarria, A.; Moug, S. J.; Gomes, C. A.; Agresta, F.; Di Saverio, S.; Catena, F.

doi:10.1186/s13017-025-00591-w

Background: During the coronavirus disease (COVID-19) pandemic, there has been a surge in cases of acute cholecystitis. The ChoCO-W global prospective study reported a higher incidence of gangrenous cholecystitis and adverse outcomes in COVID-19 patients. Through this secondary analysis of the ChoCO-W study data, we aim to identify significant risk factors for mortality in patients with acute cholecystitis during the COVID-19 pandemic, emphasizing the role of COVID-19 infection in patient outcomes and treatment efficacy.” Methods: The ChoCO-W global prospective study reported data from 2546 patients collected at 218 centers from 42 countries admitted with acute cholecystitis during the COVID-19 pandemic, from October 1, 2020, to October 31, 2021. Sixty-four of them died. Nonparametric statistical univariate analysis was performed to compare patients who died and patients who survived. Significant factors were then entered into a logistic regression model to define factors predicting mortality. Results: The significant independent factors that predicted death in the logistic regression model with were COVID-19 infection (p < 0.001), postoperative complications (p < 0.001), and type (open/laparoscopic) of surgical intervention (p = 0.003). The odds of death increased 5 times with the COVID-19 infection, 6 times in the presence of complications, and it was reduced by 86% with adequate source control. Survivors predominantly underwent urgent laparoscopic cholecystectomy (52.3% vs. 23.4%). Conclusions: COVID-19 was an independent risk factor for death in patients with acute cholecystitis. Early laparoscopic cholecystectomy has emerged as the cornerstone of treatment for hemodynamically stable patients.

COVID-19 infection is a significant risk factor for death in patients presenting with acute cholecystitis: a secondary analysis of the ChoCO-W cohort study / De Simone, B., Abu-Zidan, F.M., Kasongo, L., Moore, E.E., Podda, M., Sartelli, M., Isik, A., Bala, M., Coimbra, R., Balogh, Z.J., Rasa, K., Marchegiani, F., Schena, C.A., Deangelis, N., Di Martino, M., Ansaloni, L., Coccolini, F., Gumbs, A.A., Biffl, W.L., Pikoulis, E., et al.. - In: WORLD JOURNAL OF EMERGENCY SURGERY. - ISSN 1749-7922. - 20:1(2025), pp. 1-11. [10.1186/s13017-025-00591-w]

COVID-19 infection is a significant risk factor for death in patients presenting with acute cholecystitis: a secondary analysis of the ChoCO-W cohort study

De Simone B.;Abu-Zidan F. M.;Kasongo L.;Moore E. E.;Podda M.;Sartelli M.;Isik A.;Bala M.;Coimbra R.;Balogh Z. J.;Rasa K.;Marchegiani F.;Schena C. A.;DeAngelis N.;Di Martino M.;Ansaloni L.;Coccolini F.;Gumbs A. A.;Biffl W. L.;Pikoulis E.;Pararas N.;Chouillard E.;Garulli G.;Lacavalla D.;Andreotti D.;Occhionorelli S.;Bisetto G.;Massani M.;Tutino R.;Griggio G.;Vacante M.;Biondi A.;Agnoletti V.;Gambarini F.;Nardello O.;Pisanu A.;Gomes F. C.;Kurtenkov M.;Kirkpatrick A.;Damaskos D.;Martino C.;Gendrikson G.;Dogjani A.;Bianco F.;Romero-Vargas E.;Grassia S.;Gil-Olarte A.;Bonavina L.;Bernardi D.;Froiio C.;Tvaladze A.;Lekiashvili N.;Demetrashvili Z.;Sellappan H.;Yi R. C. X.;Khei V. T. P.;Azizan N.;Hayati F.;Zainudin S.;Kara Y.;Lopez-Ruiz J. A.;Ghoneim B.;Abdel-Elsalam W.;Khokha V.;Maltinti G.;Pantalone D.;Guagni T.;Rocha M.;de Sa T. C.;Symeonidis S.;Loutzidou L.;Ioannidis O.;Acheimastos V.;Tasis N.;Manatakis D. K.;Salobir J.;Pintar T.;Theodorou D.;Triantafyllou T.;Del Monte S. R.;Picardi B.;Rossi S.;Delis S. G.;Kaya T.;Tuncer G. K.;Atici S. D.;Nakamoto R.;Kojima M.;Shoko T.;Dalili A.;Aliakbarian M.;Saeidi S.;Gureh M.;Gupta S.;Kader S. A.;Ozkan Z.;Liman R. K.;Plehutsa O.;Knut R.;Sydorchuk R.;Miller K.;Trinh A.;Sawyer R. G.;Kedar A.;Rahim R.;Ntokos G.;Patias P.;Ghalloussi M. H.;Ayed K.;Baraket O.;Yigit D.;Iflazoglu N.;Yalkin O.;Vailas M.;Verras G. I.;Mulita F.;Keramida M. D.;Dorovinis P.;Machairas N.;Fabbri N.;Feo C. V.;Pesce A.;Norrey M.;Gurung R.;Dai N.;Gourgiotis S.;Vagios I.;Syllaios A.;Schizas D.;Negoi I.;Cannavera A.;Deserra A.;Cillara N.;Papadoliopoulou M.;Sidiropoulos T. A.;Michalopoulos N. V.;Jedamzik J.;Felsenreich D. M.;Abdel-Elsalam S.;Elbahnasawy M.;Papaconstantinou D.;Misiakos E. P.;Slavchev M.;Romano R.;Ammerata G.;Ammendola M.;Ciorbagiu M. C.;Dumitrescu T. V.;Mesina C.;Livadoti G.;Nardi M.;Olmi S.;Bonaldi M.;Uccelli M.;Gioco R.;Volpicelli A.;Veroux M.;Massalou D.;Kapiris S.;Sotiropoulou M.;Di Vita M. D. P.;Valenti M. R.;Natkaniec M.;Matyja M.;Strzalka M.;Major P.;Czyzykowski L.;Kwiatkowski A.;Waledziak M.;Riva C.;Costanzi A.;Monteleone M.;Galleano R.;Costanzo F.;Malerba M.;Sydorchuk A.;Iftoda O.;Sydorchuk L.;Bains L.;Zanzi F.;Guariniello A.;Tosi L.;Gabellini L.;Canonico G.;Anastasi A.;Casati M.;Abate E.;Laface L.;Callari C.;Viola S.;Licari L.;Agostini C.;Fortuna L.;Taddei A.;Agostinelli L.;Lucchi A.;Kolla C. -C.;Koukoulis G.;Bouliaris K.;Babiker A.;Hamid H. K. S.;Ibrahim M.;Seker A.;Ozer N.;Das K.;Chrysos E.;Lasithiotakis K.;Nikolouzakis T. K.;Akbar A.;Afzal A.;Asghar M. S.;Kurnaz E.;de Lima Bertuol J. V.;Hirano E. S.;Fraga G. P.;Skorus U.;Kenig J.;D'Alessio R.;Pignata G.;Andreuccetti J.;Nikolopoulos I.;Moric T.;Romic I.;Augustin G.;Al Bahri S.;Mousa H.;Azman A.;Zuhdi Z.;Sin B. H.;Guerci C.;Maffioli A.;Bondurri A.;Piccolo G.;Ojeda L.;Gonzalez A. R.;Vega G. M.;Negro G.;Trigiante G.;Martines G.;Carcano G.;Franchi C.;Ietto G.;Fransvea P.;Tedesco S.;Brisinda G.;Armellino M. F.;Argenio G.;Pecchini F.;Pattacini G. C.;Piccoli M.;Veneroni L.;Palini G. M.;Poillucci G.;Abdullaev A.;Gachabayov M.;Sarnari J.;Nita G.;Ferrara F.;Spolini A.;Clarizia G.;Fleres F.;Rossi E. G.;Serra F.;Gelmini R.;Clerici F.;Roscio F.;Solaini L.;Ercolani G.;D'Acapito F.;Cappellacci F.;Canu G. L.;Medas F.;Toma E. A.;Enciu O.;Shin Y. C.;Jung S. W.;Kim J. I.;Rezart S.;Andolfi E.;Bayhan Z.;Altintoprak F.;Koylu Z. A.;Polat S.;Colak E.;Muzio E.;Cappato S.;Capoglu R.;Mantoglu B.;Gonullu E.;Bagolini F.;Bombardini C.;Anania G.;Pujante A.;Nagorni E. -A.;Lostoridis E.;Azamat I.;Omarov N.;Uymaz D. S.;Aktimur Y. E.;Meric S.;Altinel Y.;Demirbas I. E.;Uzunoglu M. Y.;Altintas Y.;Bayrak M.;Vederaki S. -A.;Marinis A.;Cattaneo G. M.;Capelli P.;Conti L.;Vita D.;De Luca M.;Piatto G.;Sartori A.;Zanus G.;Grossi U.;Bonilauri S.;Luppi D.;Santarelli M.;Doria E.;Visconti D.;Giraudo G.;Borghi F.;Sasia D.;Kesetovic A.;Delibegovic S.;Barbeito S. D.;Munoz-Cruzado V. D.;Aparicio-Sanchez D.;Rispoli M.;Filippo R.;Curro G.;Capuzzolo S.;Restini E.;Cianci P.;Chuklin S.;Chooklin S.;Sebastiani E.;Travaglini G.;Cardinali L.;Vecchioni I.;Campanile F. C.;Atanasov B.;Mendoza-Moreno F.;Quiroga-Valcarcel A.;Matias-Garcia B.;Petronio B.;Zulkifli A. S. M.;Rahman K. A.;Jusoh A. C.;Ruggieri A.;Martinotti M.;Maurizi A.;Campagnacci R.;Cappellani A.;Zanghi A.;Cavallaro A.;Cianchi F.;Staderini F.;Bottari A.;Lepiane P.;Scaramuzzo R.;Balla A.;Sani M. I.;Othman M. A.;Dzulkarnaen Z. A.;Shabana A.;Hernandez A. M. P.;Amin L. A. H.;Luna A. P.;Giordano A.;Uriguen-Etxeberria A.;Estraviz-Mateos B.;Landaluce-Olavarria A.;Moug S. J.;Gomes C. A.;Agresta F.;Di Saverio S.;Catena F.

2025

Abstract

Background: During the coronavirus disease (COVID-19) pandemic, there has been a surge in cases of acute cholecystitis. The ChoCO-W global prospective study reported a higher incidence of gangrenous cholecystitis and adverse outcomes in COVID-19 patients. Through this secondary analysis of the ChoCO-W study data, we aim to identify significant risk factors for mortality in patients with acute cholecystitis during the COVID-19 pandemic, emphasizing the role of COVID-19 infection in patient outcomes and treatment efficacy.” Methods: The ChoCO-W global prospective study reported data from 2546 patients collected at 218 centers from 42 countries admitted with acute cholecystitis during the COVID-19 pandemic, from October 1, 2020, to October 31, 2021. Sixty-four of them died. Nonparametric statistical univariate analysis was performed to compare patients who died and patients who survived. Significant factors were then entered into a logistic regression model to define factors predicting mortality. Results: The significant independent factors that predicted death in the logistic regression model with were COVID-19 infection (p < 0.001), postoperative complications (p < 0.001), and type (open/laparoscopic) of surgical intervention (p = 0.003). The odds of death increased 5 times with the COVID-19 infection, 6 times in the presence of complications, and it was reduced by 86% with adequate source control. Survivors predominantly underwent urgent laparoscopic cholecystectomy (52.3% vs. 23.4%). Conclusions: COVID-19 was an independent risk factor for death in patients with acute cholecystitis. Early laparoscopic cholecystectomy has emerged as the cornerstone of treatment for hemodynamically stable patients.

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	Anno di pubblicazione
	
				2025
			
	Rivista
	
				WORLD JOURNAL OF EMERGENCY SURGERY
			
	N° del Volume
	
				20
			
	Fascicolo
	
				1
			
	Pagina iniziale
	
				1
			
	Pagina finale
	
				11
			
	Codice DOI
	
				https://dx.doi.org/10.1186/s13017-025-00591-w
			
	Codice WoS
	
				WOS:001432625400001
			
	Codice Scopus
	
				2-s2.0-85219173170
			
	Codice PubMed
	
				40001181
			
	Citazione
	
				COVID-19 infection is a significant risk factor for death in patients presenting with acute cholecystitis: a secondary analysis of the ChoCO-W cohort study / De Simone, B., Abu-Zidan, F.M., Kasongo, L., Moore, E.E., Podda, M., Sartelli, M., Isik, A., Bala, M., Coimbra, R., Balogh, Z.J., Rasa, K., Marchegiani, F., Schena, C.A., Deangelis, N., Di Martino, M., Ansaloni, L., Coccolini, F., Gumbs, A.A., Biffl, W.L., Pikoulis, E., et al.. - In: WORLD JOURNAL OF EMERGENCY SURGERY. - ISSN 1749-7922. - 20:1(2025), pp. 1-11. [10.1186/s13017-025-00591-w]
			
	Tutti gli autori
	
						De Simone, B.; Abu-Zidan, F. M.; Kasongo, L.; Moore, E. E.; Podda, M.; Sartelli, M.; Isik, A.; Bala, M.; Coimbra, R.; Balogh, Z. J.; Rasa, K.; Marcheg...espandi
						
	Tipologia
	
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