Project #210: Disparities in incidence and management of peripheral arterial disease before, during and after the COVID-19 pandemic

This study examines how the COVID‑19 pandemic affected people living with peripheral arterial disease (PAD) in England, using anonymous NHS records from January 2017 through June 2025 to compare care before, during, and after the pandemic.

PAD happens when blood flow to the legs is reduced, causing pain, slow‑healing wounds, or sometimes amputation. During COVID‑19, many NHS services were disrupted—GP appointments, scans, and elective surgeries were postponed—so people with PAD may have faced delays in diagnosis or treatment. By linking primary care records (when a GP first identifies PAD), hospital data (treatments such as angioplasty, bypass surgery, or amputation), COVID‑19 test results, and death records, we will:

(1) Measure how many new PAD cases were diagnosed each year and whether diagnoses shifted from GP clinics to emergency hospital settings.
(2) Compare early (GP) versus late (hospital) presentations and how quickly patients received treatment.
(3) Track outcomes: repeat procedures, limb‑salvage rates, amputations, and survival.
(4) Evaluate how the risk of developing PAD and the rates of PAD treatments and outcomes differed for patients who had COVID‑19 compared to those who did not, and how these differences evolved from March 2020 to June 2025.
(5) Look at differences between groups: younger vs. older patients; men vs. women; different ethnic backgrounds; areas of greater or lesser advantage; and people with other conditions like diabetes or kidney disease.

Our goal is to identify which patients were most affected by service changes or by having COVID‑19 themselves, where care gaps emerged, and to share these findings publicly so the NHS can plan more resilient, fairer PAD services, ensuring early diagnosis and timely treatment to prevent unnecessary amputations, even during future emergencies.