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.; 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.. - 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
Podda M.;Ansaloni L.;Agnoletti V.;Pisanu A.;Kaya T.;Gupta S.;Ammendola M.;Costanzo F.;Tosi L.;Anastasi A.;Callari C.;Viola S.;Taddei A.;Lucchi A.;Mousa H.;Tedesco S.;Pecchini F.;Rossi E. G.;Gelmini R.;Anania G.;Vita D.;Vecchioni I.;Agresta 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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