Assessment of quality of life in patients after endovascular revascularization in combination with catheter-directed selective thrombolysis for acute limb ischemia developed in the acute stage of the new coronavirus infection COVID-19

COVID-19 infection can be complicated by sudden occlusion of the limb arteries, significantly reducing the patient’s chances of recovery. Although surgical restoration of blood flow remains the preferred treatment for critical limb ischemia, in patients with coronavirus, such intervention is associated with an increased likelihood of recurrent thrombus formation. Objective of the study. To assess the quality of life of patients who underwent endovascular revascularization with catheter-guided selective thrombolysis using tissue plasminogen activator alteplase for acute limb ischemia (ALI) in the acute stage of COVID-19 compared to patients without viral infection. Material and methods. The study included 121 patients with ALI who underwent endovascular revascularization with selective catheter-guided thrombolysis using tissue plasminogen activator alteplase. The study group (n = 71) consisted of patients with COVID-19, while the control group (n = 50) included patients without infection. Quality of life was assessed using the SF-36 questionnaire at discharge and 12 months later. Statistical data processing was performed in the R computing and graphical analysis environment of the Comprehensive R Archive Network (CRAN). Results. In the early postoperative period, patients with COVID-19 showed a significant decrease in quality of life across all scales of the SF-36 questionnaire compared to the control group. The overall physical health component was lower by 21% (p < 0.005), and the overall mental health component was lower by 25% (p < 0.007). Twelve months after the intervention, the quality of life of patients who had COVID-19 significantly improved and approached the indicators of the control group: the overall physical health component was 54.0 compared to 55.2 (p < 0.07), and the overall mental health component was 54.2 compared to 59.5 (p = 0.065). The use of minimally invasive access and local thrombolysis reduced pain sensations, decreased the impact of physical limitations, and improved the viability of patients in the acute stage of COVID-19 according to the SF-36 scales. Conclusion. In the acute stage of COVID-19, the quality of life of patients after endovascular revascularization for ALI is significantly lower compared to the control group without coronavirus infection. However, within 12 months after the intervention, the quality of life of patients who had COVID-19 improves and approaches the indicators of the control group and average population values. This should be taken into account during the follow-up and rehabilitation of this category of patients.

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