Increased number of ruptured aortic aneurysms during SARS-CoV-2 pandemic: RAAAs during SARS-CoV-2

Background and purpose: The aim of the study was to verify whether ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic or Coronavirus disease (COVID-19) vaccination has any influence on established increased number of ruptured aortic aneurysms (RAA) during SARS-CoV-2 pandemic (years 2020-2021) regarding two-year of pre-pandemic period (2018-2019). Materials and methods: Medical records of patients treated for the ruptured abdominal aortic aneurysm (RAAA) by surgical or endovascular reconstruction at the Department of Surgery, University Hospital Center Zagreb, between 2018 and 2021, were retrospectively analyzed. Categorical variables were analyzed using Fisher’s exact test, while numerical variables were analyzed using Student’s t-test or Mann-Whitney U test, depending on the normality of the distribution. Results: The analysis revealed an increase in number of RAAAs by 55.56% in pandemic time (28 versus 18 in pre-pandemic years), decrease in their 30-day mortality by 18.65 % (53.57% vs. 72.22% respectively) and decrease in outpatient examinations during pandemic by 13.82%, but the differences were not statistically significant. Conclusion: No statistically significant relation between SARS-CoV-2 pandemic or the COVID-19 vaccination and the number of treated RAAAs could be established. History of COVID-19 positivity or vaccination were not associated with RAAA outcome. The increase of RAAAs in pandemic along with decrease of its 30-day mortality compared to pre-pandemic time suggests patients’ hesitance to go to elective surgery and avoidance of regular check-ups in the hospitals, where lots of patients with SARS-CoV-2 are presumed to be concentrated, since hospital service policy and protocols remained the same. The patients were never directly asked to answer this question, so even if the fear of getting SARS-CoV-2 infection remains the most plausible answer, it should be verified by an independent survey.