https://doi.org/10.1177/1358863X20977678 Vascular Medicine 2021, Vol. 26(2) 174–179 © The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/1358863X20977678 journals.sagepub.com/home/vmj A cross-sectional study evaluating hospitalization rates for chronic limb-threatening ischemia during the COVID-19 outbreak in Campania, Italy Eugenio Stabile 1 , Raffaele Piccolo 1 , Michele Franzese 1 , Giancarlo Accarino 2 , Umberto Marcello Bracale 3 , Enrico Cappello 4 , Giovanni Cioffi 5 , Angelo Cioppa 6 , Adolfo Crinisio 7 , Loris Flora 8 , Pietro Landino 9 , Eugenio Martelli 10 , Rosario Mancusi 11 , Raffaella Niola 12 , Fernando Petrosino 13 , Davide Razzano 14 , Carlo Ruotolo 15 , Luigi Salemme 6 , Paolo Sangiuolo 16 , Gianpaolo Santini 17 , Emilio Soreca 18 , Gennaro Vigliotti 19 , Bruno Villari 20 , Giampaolo Amabile 12 , Raffaele Pio Ammollo 3 , Danilo Barbarisi 8 , Alfonsina M Corbisiero 9 , Antonio D’angelo 2 , Gianluca Cangiano 12 , Claudia De Gregorio 11 , Mario De Laurentis 16 , Eugenio Laurenzano 20 , Ilaria Ficarelli 15 , Alessandro Luongo 13 , Claudio Molino 7 , Giuseppe Sarti 17 , Daniela Viola 19 and Giovanni Esposito 1 Abstract The expansion of coronavirus disease 2019 (COVID-19) prompted measures of disease containment by the Italian government with a national lockdown on March 9, 2020. The purpose of this study is to evaluate the rate of hospitalization and mode of in-hospital treatment of patients with chronic limb-threatening ischemia (CLTI) before and during lockdown in the Campania region of Italy. The study population includes all patients with CLTI hospitalized in Campania over a 10-week period: 5 weeks before and 5 weeks during lockdown (n = 453). Patients were treated medically and/or underwent urgent revascularization and/or major amputation of the lower extremities. Mean age was 69.2 ± 10.6 years and 27.6% of the patients were women. During hospitalization, 21.9% of patients were treated medically, 78.1% underwent revascularization, and 17.4% required amputations. In the weeks during the lockdown, a reduced rate of hospitalization for CLTI was observed compared with the weeks before lockdown (25 vs 74/100,000 inhabitants/year; incidence rate ratio: 0.34, 95% CI 0.32–0.37). This effect persisted to the end of the study period. An increased amputation rate in the weeks during lockdown was observed (29.3% vs 13.4%; p < 0.001). This study reports a reduced rate of CLTI-related hospitalization and an increased in-hospital amputation rate during lockdown in Campania. Ensuring appropriate treatment for patients with CLTI should be prioritized, even during disease containment measures due to the COVID-19 pandemic or other similar conditions. Keywords chronic limb-threatening ischemia (CLTI), COVID-19, peripheral artery disease (PAD) 1 Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Naples, Italy 2 Department of Vascular and Endovascular Surgery, AOU San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy 3 Department of Public Health, Division of Vascular Surgery, University of Naples Federico II, Naples, Italy 4 Division of Vascular and Endovascular Surgery, Mediterranea Centro Cuore, Naples, Italy 5 Division of Vascular Surgery, Ospedale Pellegrini, Naples, Italy 6 Division of Invasive Cardiology, Clinica Montevergine, Mercogliano, Italy 7 Division of Vascular and Endovascular Surgery, Clinica Salus, Battipaglia, Italy 8 Division of Vascular Surgery, AORN San Giuseppe Moscati, Avellino, Italy 9 Department of Cardiology and Cardiac Surgery, Casa di Cura S. Michele, Maddaloni, Italy 10 Division of Vascular and Endovascular Surgery, AORN Sant’Anna e San Sebastiano, Caserta, Italy 11 Division of Vascular and Endovascular Surgery, Villa dei Fiori Hospital, Acerra, Italy 12 Division of Vascular and Interventional Radiology, AORN Cardarelli, Naples, Italy 13 Division of Vascular Surgery, Presidio Ospedaliero ‘San Luca’, Vallo della Lucania, Italy 14 Division of Vascular Surgery, AO San Pio, Benevento, Italy 15 Division of Vascular Surgery, AORN Cardarelli, Naples, Italy 16 Division of Vascular Surgery, AORN Ospedali dei Colli, Monaldi Hospital, Naples, Italy 17 Department of Radiology, Ospedale del Mare, Naples, Italy 18 Department of Radiology, AO San Pio, Benevento, Italy 19 Division of Vascular Surgery, Ospedale del Mare, Naples, Italy 20 Division of Cardiology, Ospedale Sacro Cuore di Gesù, Benevento, Italy Corresponding author: Eugenio Stabile, Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Via S. Pansini, 5, Naples 80138, Italy. Email: eugenio.stabile@unina.it 977678VMJ 0 0 10.1177/1358863X20977678Vascular MedicineStabile et al. research-article 2020 Original Article