tetano
Editor, Senior Moderator
World J Emerg Surg
. 2025 Feb 25;20(1):16.
doi: 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
Belinda De Simone[SUP] 1 2 [/SUP], Fikri M Abu-Zidan[SUP] 3 [/SUP], Lucienne Kasongo[SUP] 4 [/SUP], Ernest E Moore[SUP] 5 [/SUP], Mauro Podda[SUP] 6 [/SUP], Massimo Sartelli[SUP] 7 [/SUP], Arda Isik[SUP] 8 [/SUP], Miklosh Bala[SUP] 9 [/SUP], Raul Coimbra[SUP] 10 [/SUP], Zsolt J Balogh[SUP] 11 [/SUP], Kemal Rasa[SUP] 12 [/SUP], Francesco Marchegiani[SUP] 13 [/SUP], Carlo Alberto Schena[SUP] 14 [/SUP], Nicola DèAngelis[SUP] 14 [/SUP], Marcello Di Martino[SUP] 15 16 [/SUP], Luca Ansaloni[SUP] 17 [/SUP], Federico Coccolini[SUP] 18 [/SUP], Andrew A Gumbs[SUP] 19 [/SUP], Walter L Biffl[SUP] 20 [/SUP], Emmanouil Pikoulis[SUP] 21 [/SUP], Nikolaos Pararas[SUP] 21 [/SUP], Elie Chouillard[SUP] 22 [/SUP]; ChoCO Collaborative group; Fausto Catena[SUP] 23 24 [/SUP]
Collaborators, Affiliations
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.
Keywords: Acute cholecystitis; Covid-19; Emergency; Laparoscopic cholecystectomy; Management; Mortality; Sars-CoV-2.
. 2025 Feb 25;20(1):16.
doi: 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
Belinda De Simone[SUP] 1 2 [/SUP], Fikri M Abu-Zidan[SUP] 3 [/SUP], Lucienne Kasongo[SUP] 4 [/SUP], Ernest E Moore[SUP] 5 [/SUP], Mauro Podda[SUP] 6 [/SUP], Massimo Sartelli[SUP] 7 [/SUP], Arda Isik[SUP] 8 [/SUP], Miklosh Bala[SUP] 9 [/SUP], Raul Coimbra[SUP] 10 [/SUP], Zsolt J Balogh[SUP] 11 [/SUP], Kemal Rasa[SUP] 12 [/SUP], Francesco Marchegiani[SUP] 13 [/SUP], Carlo Alberto Schena[SUP] 14 [/SUP], Nicola DèAngelis[SUP] 14 [/SUP], Marcello Di Martino[SUP] 15 16 [/SUP], Luca Ansaloni[SUP] 17 [/SUP], Federico Coccolini[SUP] 18 [/SUP], Andrew A Gumbs[SUP] 19 [/SUP], Walter L Biffl[SUP] 20 [/SUP], Emmanouil Pikoulis[SUP] 21 [/SUP], Nikolaos Pararas[SUP] 21 [/SUP], Elie Chouillard[SUP] 22 [/SUP]; ChoCO Collaborative group; Fausto Catena[SUP] 23 24 [/SUP]
Collaborators, Affiliations
- PMID: 40001181
- PMCID: PMC11853863
- 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.
Keywords: Acute cholecystitis; Covid-19; Emergency; Laparoscopic cholecystectomy; Management; Mortality; Sars-CoV-2.