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The impact of the COVID-19 pandemic on the provision, practice, and outcomes of vascular surgery (COVER) study

Cohort study, International, Multi-centre
Primary Investigator: Vascular Endovascular Research Network (VERN)
Funding: NIHR
Sponsor: University Hospitals Coventry and Warwickshire NHS Trust
Start date: 23/03/2020
End date: 01/04/2022

The COVER study was an international observational cohort study aiming to assess how the COVID-19 coronavirus pandemic has changed the medical care of patients who have artery and vein problems. This project was a three-tiered study designed to fully elucidate the impact of the COVID-19 pandemic on vascular surgery across the world. The aim of Tier 1 was to document how the provision and availability of vascular services evolves over time per unit/region/country. The aim of Tier 2 was to prospectively capture data on all vascular procedures performed during the pandemic and understand the impact on outcomes in the short and medium-term (up to 1 year). The aim of Tier 3 was to document (prospectively) deviations from standards of care/practice during the pandemic in vascular patients.

The main objective of the COVER study was to understand and evaluate the impact of the COVID-19 pandemic on global vascular practice and the effect on outcomes for patients presenting/receiving treatment during the pandemic.


All patients with a vascular pathology.

Outcomes of interest

Tier 1: state of vascular services per centre weekly.
Tier 2: procedures performed in each centre.
Tier 3: assessment of longer-term outcomes.

The study is formally supported by the Vascular Society of Great Britain and Ireland (VSGBI), the British Society for Endovascular Therapy (BSET), the Rouleaux Club, the NIHR, SingVasc and several national vascular surgery societies in Europe, Asia, Australia, New Zealand, and the Americas.


Vascular and Endovascular Research Network (VERN) COVER study collaborative*. Global impact of the first coronavirus disease 2019 (COVID-19) pandemic wave on vascular services. Br J Surg. 2020;107(11):1396-1400. doi:10.1002/bjs.11961

Benson RA, Nandhra S; The Vascular and Endovascular Research Network (VERN) COVID-19 Vascular Service (COVER) Tier 2 Study. Outcomes of Vascular and Endovascular Interventions Performed During the Coronavirus Disease 2019 (COVID-19) Pandemic. Ann Surg. 2021;273(4):630-635. doi:10.1097/SLA.0000000000004722

Nandhra S, Benson RA; Vascular and Endovascular Research Network (VERN) COVER Study Collaborative. The persistent challenges faced by vascular surgery services during the UK coronavirus pandemic: a snapshot qualitative survey. Ann R Coll Surg Engl. 2022;104(5):385-388. doi:10.1308/rcsann.2021.0202

The Vascular and Endovascular Research Network COVER Study Collaborative, The Vascular and Endovascular Research Network (VERN). The impact of the COronaVIrus Disease 2019 (COVID-19) pandemic on the clinical management of patients with vascular diseases: findings from Tier 3 of the COVID-19 Vascular sERvice (COVER) study. J.Vasc.Soc.G.B.Irel. 2022;2(1):17-25. doi: 10.54522/jvsgbi.2022.045