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International Journal of Colorectal Disease

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01-12-2021 | Colectomy | Short Communication

Colon ischemia in patients with severe COVID-19: a single-center retrospective cohort study of 20 patients

Authors: Cui Yang, Priska Hakenberg, Christel Weiß, Florian Herrle, Nuh Rahbari, Christoph Reißfelder, Julia Hardt

Published in: International Journal of Colorectal Disease | Issue 12/2021

Abstract

Purpose

Thromboembolic complications due to COVID-19 are common in patients requiring critical care and are associated with high morbidity and mortality rates. The aim of this study was to evaluate clinical manifestations and postoperative outcomes after colectomy for COVID-19-associated colonic ischemia in the first versus the second wave of the pandemic.

Methods

A retrospective cohort study of patients with severe COVID-19 at our institution between 1 March 2020 and 31 January 2021 was performed. All patients with severe COVID-19, requiring critical care and surgical treatment of colonic ischemia, were included. The main outcomes were surgical complications and mortality rate.

Results

A total of 190 patients were included of whom 20 (10.5%) patients underwent surgery for colon ischemia. Preoperatively, d-dimer was elevated, especially in the first wave (median 15.24 (interquartile range 6.00–32.00) vs. 2.09 (1.42–4.28) mg/L, p = 0.025). Twelve (60%) patients underwent a (sub)total colectomy, 7 (35%) a right hemicolectomy, and one patient (5%) an ileocecal resection. Grade 3b complications occurred in one of 5 patients (20%) in the first and in 9 of 15 patients (60%) in the second wave. The overall in-hospital mortality was similar in both waves (40% vs. 47%), with death occurring after a median stay of 21 days.

Conclusion

In this cohort study of patients with severe COVID-19 and colonic ischemia, clinical presentation and laboratory findings varied. However, the majority of patients required (sub)total colectomy. Despite a lower threshold to surgery in the second wave, mortality remained high.

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Title: Colon ischemia in patients with severe COVID-19: a single-center retrospective cohort study of 20 patients
Authors: Cui Yang
Priska Hakenberg
Christel Weiß
Florian Herrle
Nuh Rahbari
Christoph Reißfelder
Julia Hardt
Publication date: 01-12-2021
Publisher: Springer Berlin Heidelberg
Keywords: Colectomy
Colectomy
SARS-CoV-2
COVID-19
Hemicolectomy
Hemicolectomy
Published in: International Journal of Colorectal Disease / Issue 12/2021
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-021-03999-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Colon ischemia in patients with severe COVID-19: a single-center retrospective cohort study of 20 patients

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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