Title (english) The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis?
Author Belinda De Simone
Author Fikri M. Abu-Zidan
Author Elie Chouillard
Author Salomone Di Saverio
Author Massimo Sartelli
Author Mauro Podda
Author Carlos Augusto Gomes
Author Ernest E. Moore
Author Susan J. Moug
Author Luca Ansaloni
Author Yoram Kluger
Author Federico Coccolini
Author Aitor Landaluce-Olavarria
Author Begoña Estraviz-Mateos
Author Ana Uriguen-Etxeberria
Author Alessio Giordano
Author Alfonso Palmieri Luna
Author Luz Adriana Hernández Amín
Author Adriana María Palmieri Hernández
Author Amanda Shabana
Author Zakaria Andee Dzulkarnaen
Author Muhammad Asyraf Othman
Author Mohamad Ikhwan Sani
Author Andrea Balla
Author Rosa Scaramuzzo
Author Pasquale Lepiane
Author Andrea Bottari
Author Fabio Staderini
Author Fabio Cianchi
Author Andrea Cavallaro
Author Antonio Zanghì
Author Alessandro Cappellani
Author Roberto Campagnacci
Author Angela Maurizi
Author Mario Martinotti
Author Annamaria Ruggieri
Author Asri Che Jusoh
Author Karim Abdul Rahman
Author Anis Suraya M. Zulkifli
Author Barbara Petronio
Author Belén Matías-García
Author Ana Quiroga-Valcárcel
Author Fernando Mendoza-Moreno
Author Boyko Atanasov
Author Fabio Cesare Campanile
Author Ilaria Vecchioni
Author Luca Cardinali
Author Grazia Travaglini
Author Elisa Sebastiani
Author Serge Chooklin
Author Serhii Chuklin
Author Pasquale Cianci
Author Enrico Restini
Author Sabino Capuzzolo
Author Giuseppe Currò
Author Rosalinda Filippo
Author Michele Rispoli
Author Daniel Aparicio-Sánchez
Author Virginia Durán Muñóz-Cruzado
Author Sandra Dios Barbeito
Author Samir Delibegovic
Author Amar Kesetovic
Author Diego Sasia
Author Felice Borghi
Author Giorgio Giraudo
Author Diego Visconti
Author Emanuele Doria
Author Mauro Santarelli
Author Davide Luppi
Author Stefano Bonilauri
Author Ugo Grossi
Author Giacomo Zanus
Author Alberto Sartori
Author Giacomo Piatto
Author Maurizio De Luca
Author Domenico Vita
Author Luigi Conti
Author Patrizio Capelli
Author Gaetano Maria Cattaneo
Author Athanasios Marinis
Author Styliani-Aikaterini Vederaki
Author Mehmet Bayrak
Author Yasemin Altıntas
Author Mustafa Yener Uzunoglu
Author Iskender Eren Demirbas
Author Yuksel Altinel
Author Serhat Meric
Author Yunus Emre Aktimur
Author Derya Salim Uymaz
Author Nail Omarov
Author Ibrahim Azamat
Author Eftychios Lostoridis
Author Eleni-Aikaterini Nagorni
Author Antonio Pujante
Author Gabriele Anania
Author Cristina Bombardini
Author Francesco Bagolini
Author Emre Gonullu
Author Baris Mantoglu
Author Recayi Capoglu
Author Stefano Cappato
Author Elena Muzio
Author Elif Colak
Author Suleyman Polat
Author Zehra Alan Koylu
Author Fatih Altintoprak
Author Zülfü Bayhan
Author Emrah Akin
Author Enrico Andolfi
Author Sulce Rezart
Author Jae Il Kim
Author Sung Won Jung
Author Yong Chan Shin
Author Octavian Enciu
Author Elena Adelina Toma
Author Fabio Medas
Author Gian Luigi Canu
Author Federico Cappellacci
Author Fabrizio D’Acapito
Author Giorgio Ercolani
Author Leonardo Solaini
Author Francesco Roscio
Author Federico Clerici
Author Roberta Gelmini
Author Francesco Serra
Author Elena Giulia Rossi
Author Francesco Fleres
Author Guglielmo Clarizia
Author Alessandro Spolini
Author Francesco Ferrara
Author Gabriela Nita
Author Jlenia Sarnari
Author Mahir Gachabayov
Author Abakar Abdullaev
Author Gaetano Poillucci
Author Gian Marco Palini
Author Simone Veneroni
Author Gianluca Garulli
Author Micaela Piccoli
Author Gianmaria Casoni Pattacini
Author Francesca Pecchini
Author Giulio Argenio
Author Mariano Fortunato Armellino
Author Giuseppe Brisinda
Author Silvia Tedesco
Author Pietro Fransvea
Author Giuseppe Ietto
Author Caterina Franchi
Author Giulio Carcano
Author Gennaro Martines
Author Giuseppe Trigiante
Author Giulia Negro
Author Gustavo Machain Vega
Author Agustín Rodríguez González
Author Leonardo Ojeda
Author Gaetano Piccolo
Author Andrea Bondurri
Author Anna Maffioli
Author Claudio Guerci
Author Boo Han Sin
Author Zamri Zuhdi
Author Azlanudin Azman
Author Hussam Mousa
Author Shadi al Bahri
Author Goran Augustin
Author Ivan Romić
Author Trpimir Morić
Author Ioannis Nikolopoulos
Author Jacopo Andreuccetti
Author Giusto Pignata
Author Rossella D’Alessio
Author Jakub Kenig
Author Urszula Skorus
Author Gustavo Pereira Fraga
Author Elcio Shiyoiti Hirano
Author Jackson Vinícius de Lima Bertuol
Author Arda Isik
Author Eray Kurnaz
Author Mohammad Sohail Asghar
Author Ameer Afzal
Author Ali Akbar
Author Taxiarchis Konstantinos Nikolouzakis
Author Konstantinos Lasithiotakis
Author Emmanuel Chrysos
Author Koray Das
Author Nazmi Özer
Author Ahmet Seker
Author Mohamed Ibrahim
Author Hytham K. S. Hamid
Author Ahmed Babiker
Author Konstantinos Bouliaris
Author George Koukoulis
Author Chrysoula-Christina Kolla
Author Andrea Lucchi
Author Laura Agostinelli
Author Antonio Taddei
Author Laura Fortuna
Author Carlotta Agostini
Author Leo Licari
Author Simona Viola
Author Cosimo Callari
Author Letizia Laface
Author Emmanuele Abate
Author Massimiliano Casati
Author Alessandro Anastasi
Author Giuseppe Canonico
Author Linda Gabellini
Author Lorenzo Tosi
Author Anna Guariniello
Author Federico Zanzi
Author Lovenish Bains
Author Larysa Sydorchuk
Author Oksana Iftoda
Author Andrii Sydorchuk
Author Michele Malerba
Author Federico Costanzo
Author Raffaele Galleano
Author Michela Monteleone
Author Andrea Costanzi
Author Carlo Riva
Author Maciej Walędziak
Author Andrzej Kwiatkowski
Author Łukasz Czyżykowski
Author Piotr Major
Author Marcin Strzałka
Author Maciej Matyja
Author Michal Natkaniec
Author Maria Rosaria Valenti
Author Maria Domenica Pia Di Vita
Author Maria Sotiropoulou
Author Stylianos Kapiris
Author Damien Massalou
Author Massimiliano Veroux
Author Alessio Volpicelli
Author Rossella Gioco
Author Matteo Uccelli
Author Marta Bonaldi
Author Stefano Olmi
Author Matteo Nardi
Author Giada Livadoti
Author Cristian Mesina
Author Theodor Viorel Dumitrescu
Author Mihai Calin Ciorbagiu
Author Michele Ammendola
Author Giorgio Ammerata
Author Roberto Romano
Author Mihail Slavchev
Author Evangelos P. Misiakos
Author Emmanouil Pikoulis
Author Dimitrios Papaconstantinou
Author Mohamed Elbahnasawy
Author Sherief Abdel-elsalam
Author Daniel M. Felsenreich
Author Julia Jedamzik
Author Nikolaos V. Michalopoulos
Author Theodoros A. Sidiropoulos
Author Maria Papadoliopoulou
Author Nicola Cillara
Author Antonello Deserra
Author Alessandro Cannavera
Author Ionuţ Negoi
Author Dimitrios Schizas
Author Athanasios Syllaios
Author Ilias Vagios
Author Stavros Gourgiotis
Author Nick Dai
Author Rekha Gurung
Author Marcus Norrey
Author Antonio Pesce
Author Carlo Vittorio Feo
Author Nicolo’ Fabbri
Author Nikolaos Machairas
Author Panagiotis Dorovinis
Author Myrto D. Keramida
Author Francesk Mulita
Author Georgios Ioannis Verras
Author Michail Vailas
Author Omer Yalkin
Author Nidal Iflazoglu
Author Direnc Yigit
Author Oussama Baraket
Author Karim Ayed
Author Mohamed hedi Ghalloussi
Author Parmenion Patias
Author Georgios Ntokos
Author Razrim Rahim
Author Miklosh Bala
Author Asaf Kedar
Author Robert G. Sawyer
Author Anna Trinh
Author Kelsey Miller
Author Ruslan Sydorchuk
Author Ruslan Knut
Author Oleksandr Plehutsa
Author Rumeysa Kevser Liman
Author Zeynep Ozkan
Author Saleh Abdel Kader
Author Sanjay Gupta
Author Monika Gureh
Author Sara Saeidi
Author Mohsen Aliakbarian
Author Amin Dalili
Author Tomohisa Shoko
Author Mitsuaki Kojima
Author Raira Nakamoto
Author Semra Demirli Atici
Author Gizem Kilinc Tuncer
Author Tayfun Kaya
Author Spiros G. Delis
Author Stefano Rossi
Author Biagio Picardi
Author Simone Rossi del Monte
Author Tania Triantafyllou
Author Dimitrios Theodorou
Author Tadeja Pintar
Author Jure Salobir
Author Dimitrios K. Manatakis
Author Nikolaos Tasis
Author Vasileios Acheimastos
Author Orestis Ioannidis
Author Lydia Loutzidou
Author Savvas Symeonidis
Author Tiago Correia de Sá
Author Mónica Rocha
Author Tommaso Guagni
Author Desiré Pantalone
Author Gherardo Maltinti
Author Vladimir Khokha
Author Wafaa Abdel-elsalam
Author Basma Ghoneim
Author José Antonio López-Ruiz
Author Yasin Kara
Author Syaza Zainudin
Author Firdaus Hayati
Author Nornazirah Azizan
Author Victoria Tan Phooi Khei
Author Rebecca Choy Xin Yi
Author Harivinthan Sellappan
Author Zaza Demetrashvili
Author Nika Lekiashvili
Author Ana Tvaladze
Author Caterina Froiio
Author Daniele Bernardi
Author Luigi Bonavina
Author Angeles Gil-Olarte
Author Sebastiano Grassia
Author Estela Romero-Vargas
Author Francesco Bianco
Author Andrew A. Gumbs
Author Agron Dogjani
Author Ferdinando Agresta
Author Andrey Litvin
Author Zsolt J. Balogh
Author George Gendrikson
Author Costanza Martino
Author Dimitrios Damaskos
Author Nikolaos Pararas
Author Andrew Kirkpatrick
Author Mikhail Kurtenkov
Author Felipe Couto Gomes
Author Adolfo Pisanu
Author Oreste Nardello
Author Fabrizio Gambarini
Author Hager Aref
Author Nicola de’ Angelis
Author Vanni Agnoletti
Author Antonio Biondi
Author Marco Vacante
Author Giulia Griggio
Author Roberta Tutino
Author Marco Massani
Author Giovanni Bisetto
Author Savino Occhionorelli
Author Dario Andreotti
Author Domenico Lacavalla
Author Walter L. Biffl
Author Fausto Catena
Author's institution University of Zagreb School of Medicine (Department of Surgery)
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Surgery
Abstract (english) 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.
Keywords (english)
COVID-19 / epidemiology
Cholecystitis / epidemiology
Cholecystitis / surgery
Cholecystitis, Acute / epidemiology
Cholecystitis, Acute / surgery
Female
Humans
Male
Middle Aged
Pandemics
Postoperative Complications / epidemiology
SARS-CoV-2
Sepsis
Language english
Publication type Scientific paper - Original scientific paper
Publication status Published
Peer review Peer review
Publication version Published version
Journal title World Journal of Emergency Surgery
Numbering vol. 17, no. 1, 61
e-ISSN 1749-7922
DOI https://doi.org/10.1186/s13017-022-00466-4
URN:NBN urn:nbn:hr:105:566537
Publication 2022-12-16
Document URL https://wjes.biomedcentral.com/articles/10.1186/s13017-022-00466-4
Type of resource Text
Access conditions Open access
Terms of use
Created on 2023-05-16 08:03:43