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May 14, 2020

VERN Launches International Collaborative Assessment of Vascular Surgery Practice During COVID-19 Pandemic

May 14, 2020—The United Kingdom’s Vascular and Endovascular Research Network (VERN) Executive Committee announced the initiation of the COVER study, an international collaborative assessment of the provision, practice, and outcomes of vascular surgery during the COVID-19 pandemic, which is having a profound impact on worldwide health care systems. VERN invites all vascular and endovascular surgeons to participate in the study.

The VERN Executive Committee outlined the study in a research letter published online in European Journal of Vascular and Endovascular Surgery (EJVES) and stated, “There is an urgent need to quantify the impact of the pandemic on the provision of vascular and endovascular surgery, delays to treatment, and the adjustments made to standard vascular practice.”

A detailed study protocol and research documents are available online, including a generic protocol for international centers to use to produce a locally applicable protocol.

As reported in EJVES, COVER is a three-tiered international study designed to capture global data on vascular practice during the pandemic.

Tier 1: Repeated assessment and reporting of changes to unit-level processes via an online data collection tool

  • Tier 1 can be found at online VERN’s COVER Survey Monkey site, where the vascular and endovascular surgery community is encouraged to communicate fortnightly on how the pandemic is affecting their practice.
  • There are 320 centers from 46 countries in Europe, North America, South America, Australasia, the Middle East, and Asia documenting evolving practice.
  • As of the time that the letter was submitted, international trends include deployment of team members to other specialties; rapid uptake of telemedicine clinics; no country other than Germany has reported 100% availability of personal protective equipment in all participating centers; and aortic aneurysm screening continues in some United Kingdom centers.

Tier 2: Procedural data capture

  • This tier involves recording consecutive vascular and endovascular interventions undertaken during a 12-week period, with the aim of documenting changes to standard operational practice for common vascular conditions.
  • Follow-up at 6 and 12 months will link changes in procedural practice to condition-specific morbidity and mortality, and especially cardiovascular complications, in this exceptionally high-risk patient cohort.

Tier 3: Changes to vascular care

  • This tier will capture details of consecutive vascular referrals during a 1-month period.
  • The aim is to demonstrate changing patterns of referrals and document alterations in patient management and to look at 6- and 12-month outcomes for patients who would normally have undergone a surgical procedure before the COVID-19 outbreak.
  • This also has significant potential to inform the management of patients after the COVID-19 pandemic passes.

Tiers 2 and 3 have now started recruitment internationally.

“We hope that COVER will go some way toward understanding the effect of this unique crisis on vascular patients and their outcomes. It will provide data for use during this and any future disasters and will add to our understanding of the effect of public health emergencies on our specialty, our patients, and our health care systems,” concluded the VERN Executive Committee in the letter in EJVES.

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