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
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.” 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. 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%). 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. Study Objective: Investigated the factors predicting mortality in patients with acute cholecystitis during the COVID-19 pandemic. Cohort Size: Analyzed 2,546 patients from 218 centers in 42 countries between October 2020 and October 2021. Key Findings: COVID-19 infection increased mortality risk by five times in patients with acute cholecystitis. Postoperative complications elevated the odds of death sixfold. Early laparoscopic cholecystectomy significantly reduced mortality by 86%. Surgical Impact: Survivors were more likely to have undergone urgent laparoscopic surgery, suggesting it as a safer intervention during the pandemic. Clinical Relevance: COVID-19 was confirmed as an independent predictor of death, highlighting the need for urgent intervention in stable patients with acute cholecystitis. Study Objective: Investigated the factors predicting mortality in patients with acute cholecystitis during the COVID-19 pandemic. Cohort Size: Analyzed 2,546 patients from 218 centers in 42 countries between October 2020 and October 2021. Key Findings: COVID-19 infection increased mortality risk by five times in patients with acute cholecystitis. Postoperative complications elevated the odds of death sixfold. Early laparoscopic cholecystectomy significantly reduced mortality by 86%. Surgical Impact: Survivors were more likely to have undergone urgent laparoscopic surgery, suggesting it as a safer intervention during the pandemic. Clinical Relevance: COVID-19 was confirmed as an independent predictor of death, highlighting the need for urgent intervention in stable patients with acute cholecystitis.