COVID-19 Vaccination Reduces Lower Limb Amputation Rates and Mortality Rate in Patients with Pre-Existing Peripheral...

Area of Science:

• Vascular Medicine
• Infectious Diseases
• Vaccinology

Background:

• Unvaccinated individuals with peripheral arterial occlusive disease (PAOD) face a higher risk of acute limb ischemia (ALI) post-SARS-CoV-2 infection.
• The protective impact of COVID-19 vaccination against ALI in PAOD patients with SARS-CoV-2 infection requires thorough assessment.

Purpose of the Study:

• To evaluate the protective effect of COVID-19 vaccination in preventing ALI among PAOD patients diagnosed with SARS-CoV-2 infection.
• To compare the incidence of lower limb amputation and all-cause mortality in vaccinated versus unvaccinated PAOD patients with SARS-CoV-2 infection.

Main Methods:

• Retrospective cohort study utilizing the US TriNetX database (November 2020 - December 2023).
• Inclusion of PAOD patients diagnosed with SARS-CoV-2 infection, with propensity score matching for demographic, lifestyle, comorbidity, and utilization variables.
• Comparison of 11,822 matched pairs of vaccinated and unvaccinated PAOD patients using Cox proportional hazards models and Kaplan-Meier analysis for 3-year outcomes.

Main Results:

• COVID-19 vaccinated PAOD patients demonstrated a significantly lower risk of 3-year all-cause mortality (HR=0.857, p<0.001) and lower limb amputation (HR=0.716, p=0.001).
• No significant difference in the risk of ischemic stroke was observed between vaccinated and unvaccinated PAOD patients (HR=0.958, p=0.174).
• The study analyzed 12,948 vaccinated and 44,064 unvaccinated PAOD patients with SARS-CoV-2 infection.

Conclusions:

• COVID-19 vaccination provides a significant protective benefit against 3-year all-cause mortality and lower limb amputation in PAOD patients with SARS-CoV-2 infection.
• Vaccination does not appear to significantly impact the risk of ischemic stroke in this patient cohort.
• The findings underscore the importance of COVID-19 vaccination for PAOD patients to mitigate severe outcomes following SARS-CoV-2 infection.